Tag: dialysis (Page 39 of 50)

The Lifesaving Power of Regular Workouts for Peritoneal Dialysis Patients

June 23, 2023 / Henry Feeser / 1 Comment

Alex Janin writing in recent Wall Street Journal articles describes the longevity benefits of regular workouts. We herein draw on her articles detailing how such insightfulness applies to those of us on peritoneal dialysis regardless of age.

Introduction:

Living with peritoneal dialysis can be a challenging journey, but there are steps we can take to improve our health and well-being. While exercise is often associated with maintaining physical fitness and preventing chronic conditions, its positive impact extends far beyond that. In this blog entry, we will explore how the insightful findings on exercise’s benefits can be applied to peritoneal dialysis patients of all ages, offering a ray of hope and a path to better health. For each, I provide how I operationalize the concept in my own exercise regimen.

Improved Cardiovascular Health:

Regular exercise has a profound effect on cardiovascular health, which is particularly crucial for peritoneal dialysis patients. Engaging in aerobic activities, such as walking, swimming, or cycling, helps strengthen the heart, improve blood circulation, and enhance lung function. By incorporating regular workouts into their routine, peritoneal dialysis patients can reduce the risk of cardiovascular complications, such as heart disease and hypertension, both of which are common among individuals with kidney disease.

As I have previously blogged about, with malice of forethought, my wife and I brought onboard a frisky male golden retriever named Dickens. From my perspective, I agreed to have the third golden in our lives for a very selfish reason – I knew he would need to be exercised night and day, and that I would be part of that effort. It has paid off. I walk him faithfully every morning, regardless of the temperature or weather. He is a golden and essentially impervious to the elements and ready to go without regard to global warming.

The second incentive in this area is I gave my wife an electric bike for Christman. Of course, I have to go on bike rides with her so I bought myself one that also has a seven-speed pedal assist. My intent is to incorporate bike riding into my exercise.

The third incentive I took was to gift my wife and me a set of pickleball rackets and paraphernalia. We have several pickleball courts in Heaven on Earth where we live to take advantage of.

The fourth is we have a massive amount of flowers and veggies growing on the half-acre lot that is our manicured yard which I am essentially the sole caretaker of. This involves gobs of up and down and weeding and pulling and tugging and just plain work. This is especially true in North Texas weather where we are scheduled to be in triple digits for about 40 days this summer.

Lastly, our son is building an ICF home about 45 minutes NE of us. At least once a week I try to spend most of a day with him working on some aspect of the building, usually involving something electrical where I can put my BS/MSEE to best advantage for him. See the video embedded at this blog’s end for a walkaround of what an ICF-built home looks like.

Enhanced Mental Well-being:

Dealing with a chronic illness like peritoneal dialysis can take a toll on mental health. Fortunately, exercise has been proven to be a powerful mood booster and stress reliever. Physical activity stimulates the release of endorphins, which are natural mood enhancers. Engaging in regular workouts not only helps combat anxiety and depression but also promotes a sense of well-being and improves overall mental resilience.

Writing this blog has improved my mental health. It has made me more attentive to detail, and always on the lookout for ideas or concepts that may provide insight to others through my writing.

Weight Management and Muscle Strength:

Maintaining a healthy weight is crucial for peritoneal dialysis patients, as excess weight can put additional strain on the body and exacerbate existing health conditions. Regular exercise, combined with a balanced diet, can help manage weight effectively. Additionally, incorporating strength training exercises into the workout routine can improve muscle strength and endurance, further supporting the body’s ability to perform daily activities and improve the overall quality of life.

Excess weight has not been a problem for me. Before my eGFR tanked, I weighed in the 162-164 range consistently. Once my eGFR tanked, I got down to 137 at which time I started dialysis. My weight now is in the 149-152 range and is fairly consistent and holding.

Bone Health and Joint Function:

Peritoneal dialysis patients are at an increased risk of developing bone and joint problems due to mineral and vitamin deficiencies. Weight-bearing exercises, such as walking or lifting weights, can help improve bone density and strengthen muscles, reducing the risk of fractures and improving overall bone health. Furthermore, regular workouts can alleviate joint pain and stiffness, enhancing mobility and allowing patients to engage in their daily activities with greater ease.

Bone density is of concern to my GP, especially at my age. In the past weeks, I have had a bone density scan and will report results when I know them. This is an area of concern.

Increased Energy Levels:

Living with peritoneal dialysis often leads to feelings of fatigue and low energy levels. Paradoxically, engaging in regular exercise can actually boost energy levels and reduce feelings of tiredness. Exercise increases oxygen and nutrient delivery to the body’s tissues, improves sleep quality, and enhances overall stamina, resulting in increased energy levels throughout the day.

I don’t nap during the day and have no problems going to sleep once I hook up to the cycler and start my nightly dialysis routine. I attribute this to getting plenty of exercise and eating what is dictated that I need to eat.

Conclusion:

While peritoneal dialysis presents its challenges, incorporating regular workouts into your lifestyle can have a transformative impact on your health and well-being. As highlighted by Alex Janin’s insightful Wall Street Journal articles, exercise offers numerous benefits for longevity, and these benefits extend to peritoneal dialysis patients of all ages. By embracing physical activity, you can improve cardiovascular health, boost mental well-being, manage weight effectively, strengthen bones and joints, and increase your energy levels.

Attribution: WSJ ‘s Alex Janin for inspiration, AI for aide and attendance.

Problems Faced in Dialysis: A Content Analysis of Responses

June 22, 2023 / Henry Feeser / 0 Comments

On the Fresenius-sponsored PatientHub app, the moderator posted the following question: “What is the biggest hurdle you’ve overcome while on home dialysis?” Over a four-year period, there were 63 responses to the question. I thought it would be nice to summarize for readers of this blog what actual patients on PD reported. Thus, this blog entry.

In statistics, there is a methodology named “content analysis.”
Content analysis is a statistical methodology used to analyze text data by categorizing or coding the content into various groups. The process involves identifying specific words, themes, characters, or concepts within the text and quantifying their frequency or pattern of occurrence. This objective, systematic, and quantitative description of the manifest content of communication allows for inferences to be made about the messages within the texts, the sender(s), the audience, or the culture and time of its creation. The methodology can be applied to a broad array of texts, such as speeches, interviews, articles, social media posts, and more, allowing researchers to draw empirical insights from qualitative data.

Methodology: I cut and pasted all of the responses into a Word document. I then copied this Word document and pasted it into my ChatGPT4 bot and instructed it to run a content analysis on the input and provide a summary output. This output is next:

The content analysis of the provided text reveals several themes and challenges faced by individuals undergoing peritoneal dialysis (PD) treatment. The identified themes include:

Diet: Many individuals mention the challenge of managing their diet, particularly in relation to phosphorus intake. The love for certain foods like cheese can make it difficult to adhere to dietary restrictions.
Sleep and discomfort: Sleep-related issues are a common hurdle. People mention difficulty sleeping due to the noise and light from the cycler machine. Staying still during sleep can also be a challenge, leading to concerns about inadvertently causing complications such as infiltrating venous needles.
Storage and space management: The storage and organization of supplies can pose logistical challenges, especially for individuals with limited space. The large quantity of supplies delivered can be overwhelming and may require dedicated storage areas.
Infection and complications: Infections, graft ruptures, and other complications are mentioned as significant hurdles in the PD treatment process. These complications can lead to additional interventions, changes in treatment modalities, and emotional distress.
Weight management: Weight gain or loss can be challenging for individuals on PD. Balancing nutritional needs, limited dietary options, and the effects of dialysis on metabolism can make weight management difficult.
Emotional and psychological impact: Various emotional and psychological challenges are discussed, including guilt, shame, body image concerns, frustration, and anxiety. People share their experiences of feeling like a burden, dealing with insecurities, and navigating changes in relationships and sexuality.
System and healthcare provider challenges: Some individuals express frustration with the supply chain, pharmacy services, and healthcare providers. Issues with ordering, lack of communication, and perceived indifference from healthcare teams are mentioned as challenges that could be addressed to improve the overall experience of PD treatment.
Time management and routine: Establishing and maintaining a routine that accommodates treatment, work, appointments, and other responsibilities is highlighted as an anxiety-inducing task. The need to calculate preparation time, dialysis time, and other factors adds to the complexity.
Fatigue: Several individuals mention feeling tired or experiencing a lack of energy, which can be a persistent challenge in managing daily activities alongside PD treatment.

This content analysis provides insight into the lived experiences of individuals undergoing PD treatment, shedding light on the diverse challenges they face and the strategies they employ to overcome them.

Subjective Age Bias and Its Implications for Patients on Peritoneal Dialysis

June 21, 2023 / Henry Feeser / 0 Comments

Age, as we traditionally understand it, is a numerical construct, straightforward and unchanging. However, the concept of age is multi-dimensional, encompassing not just chronological age (the number of years a person has lived), but also perceived or subjective age (how old a person feels). Research has shown that there can be a significant discrepancy between a person’s chronological and subjective age, a phenomenon known as subjective age bias.

Subjective age bias is the discrepancy between one’s chronological age and how old one feels. This bias can manifest in two ways: individuals may feel younger or older than their chronological age. While feeling younger may seem like a positive bias, both directions of bias can have implications for health and well-being. For instance, those who feel significantly younger may engage in behaviors that are more suitable for younger individuals, which could potentially harm their health. On the other hand, feeling significantly older could lead to reduced motivation, social engagement, or physical activity.

This concept has important implications in the healthcare setting. Subjective age bias can significantly impact health outcomes, patient compliance, and overall quality of life. One specific area where the subjective age bias is particularly relevant is in patients undergoing peritoneal dialysis for end-stage renal disease.

Peritoneal dialysis (PD) is a treatment for patients with severe chronic kidney disease. The process involves using the patient’s peritoneum in the abdomen as a membrane across which fluids and substances are exchanged from the blood. It requires rigorous self-care practices and adherence to a strict schedule, making it a demanding therapy that can significantly impact a patient’s lifestyle.

Subjective age can influence how these patients perceive their ability to manage their disease and their treatment. For instance, patients who feel younger may be more optimistic and motivated to adhere to the strict routine required by PD. They may view the disease as a temporary setback and remain hopeful about their recovery. This can lead to better compliance with treatment regimens, less psychological distress, and ultimately better health outcomes.

Conversely, PD patients who feel older than their chronological age may feel overwhelmed by their disease and the demands of their treatment. They may perceive the disease as an inevitable part of aging and have less hope for their recovery. This can lead to poorer compliance, increased psychological distress, and worse health outcomes.

However, it’s important to note that these are general trends, and individual experiences can vary widely. Healthcare providers should be aware of the subjective age bias and consider their patient’s subjective age when planning and providing care. For example, motivational interviewing and psychological support could be particularly beneficial for PD patients who feel older than their chronological age. On the other hand, patients who feel younger might benefit from education about the importance of adhering to treatment regimens, despite feeling healthier or more capable than their chronological age would suggest.

In conclusion, subjective age bias is a significant factor that can influence the health and well-being of patients on peritoneal dialysis. By understanding this bias and its implications, healthcare providers can provide more personalized and effective patient care. The psychological aspects of age perception are just as important as the physical realities of aging, and they should be considered an integral part of holistic healthcare.

How do we measure where a person lies along the subjective age bias spectrum?

Subjective age bias is typically measured through self-report questionnaires or surveys. The simplest method involves asking people to state the age they feel, often in comparison to their chronological age. For example, an individual might be asked: “Regardless of your chronological age, what age do you feel most of the time?”

Responses can range from much younger to much older than one’s chronological age, or they may coincide with chronological age if a person feels their ‘actual’ age. These responses can then be analyzed to determine if an individual has a subjective age bias and, if so, in which direction.

Another approach is to ask people to indicate how old they feel on a scale, such as from 0 (as young as possible) to 100 (as old as possible), or to rate their subjective age in relation to a series of age groups.

There are also more detailed questionnaires that consider different aspects of subjective age, such as physical health, mental health, or cognitive functioning. These surveys may ask respondents to rate their perceived age in these specific areas, which can provide a more nuanced understanding of subjective age bias.

However, it’s important to note that subjective age is a complex construct that many factors, including cultural, social, and individual differences, can influence. Therefore, measuring subjective age bias is not an exact science, and the results should be interpreted with this in mind.

It’s also worth noting that subjective age and its biases can change over time, influenced by factors such as health status, life events, or changes in self-perception. Therefore, it can be beneficial to measure subjective age at multiple time points to track these changes and provide a more comprehensive picture of an individual’s subjective age bias.

The above post was seeded by an article in psypost.org on June 7, 2023, by Eric W. Dolan from Social Psychology titled “Subjective age bias Psychologists uncover a fascinating historical trend.” The article’s lead paragraph states, “Do you feel younger than your chronological age? You are not alone. Research has shown that most middle-aged and older adults feel younger than they actually are, and this phenomenon has been labeled subjective age bias. Interestingly, new research provides evidence that this effect is increasing over time. Individuals from more recent birth cohorts tend to exhibit a greater subjective age bias compared to those from earlier cohorts.”

Attribution: I was assisted in this blog post by the referenced article, ChatGPT4, Bing Illustrator for the lead graphic, Grammarly to clean up my typos, and me for the remainder. Any errors are human; any insights are divine.

Bits and Bobs and Dialysis

June 20, 2023 / Henry Feeser / 0 Comments

Once upon a time, my wife made an antique-buying trip to Jolly Ole, England. While there, she happened across the phrase “Bits and Bobs” and named her antique business the same. So what is this phrase, and how does it apply to dialysis?

“Bits and bobs” is a common British English phrase that means various small items or odds and ends. It’s akin to the American English phrase “this and that.” The phrase is thought to have originated from the world of carpentry, where “bits” could refer to small pieces of wood, while “bobs” was a term for small things or minor tasks. So herein, it means odds and ends pertaining to dialysis to catch us up on the minutia in the life of someone on PD.

Recently my evening on dialysis was hell. Every drain, all four of them, resulted in multiple alarms. I could only quiet these alarms by standing up on both feet for approaching half-hour for each drain. Remember that this happens regularly at about midnight, 0230, 0500, etc. Not very conducive to a good night’s sleep. Of course, I was blaming the cycler for being problematic based on past experiences with it. I was wrong – very wrong.

It turns out that when I set up the cycler the evening before, I neglected to remove the end cap from the drain line. While drain fluid can be forced out of the cap end under pressure, the system is not designed to do so and leaving the cap on restricted drainage. It was a problem of my own making.

There is a lesson here for all of us. We can NEVER lose sight that dialysis requires immense attention to detail. One little slip and problems much greater than losing sleep could result. This is especially cogent in the area of being fastidiously clean about any and all aspects of dialysis care and feeding. Fresenius provided me a sign that hangs over my prep station that reads, “If you even think you contaminated, you did!” I have added a check that the end cap is on the sink countertop as part of my mental checklist in the cycler setup. Hopefully, this is a one-and-done occurrence.

Last week I had a supply delivery. The day before, I received a garbled robocall from Fresenius along the lines that the delivery would be short. I called in and was told that the 1.5% five-liter dialysis solution was still in quality assurance and would be delivered later on—no idea when, just in due course. Delivery day came, and Fresenius logistics provided a window of 0900 to 1300. The delivery was actually made after 1600. As you may surmise, we’re not doing so well thus far. Two days later, after another call, the back-ordered solution was delivered.

Another lesson for the wise on dialysis – always have several weeks of backup supplies on hand even though this is a PITA. You never know when something like this will happen despite best effort on the part of all concerned.

The last bits and bobs has to do with CGMs, continuous glucose monitors. After going round and round with my GP and CVS, and Medicare, I found out via independent research that the Abbott Libre 3 is not yet approved by Medicare; the Dextron 7 is as is the Libre 2, but NOT the 3. The 7 is much more expensive, lasts only 10 days, and does not appear to have as well-developed an interface as the 3. So I have opted to continue to track approval of the Libre 3 and will buy it out-of-pocket for the time being.

Attribution: Only human intelligence was used in writing this blog, such as it is 🙂

The Power of Self-Efficacy in Peritoneal Dialysis Patients

June 19, 2023 / Henry Feeser / 0 Comments

Peritoneal dialysis (PD) is a life-sustaining treatment for patients with end-stage renal disease. It requires a significant level of patient involvement and self-care, making it a unique medical treatment that places a considerable amount of responsibility on the patient. One psychological concept that plays a crucial role in the successful management of PD is self-efficacy.

Self-efficacy, a term coined by psychologist Albert Bandura, refers to an individual’s belief in their ability to succeed in specific situations or accomplish a task. It’s about having confidence in the ability to exert control over one’s own motivation, behavior, and social environment. In the context of PD, self-efficacy can significantly influence a patient’s ability to manage their treatment effectively.

Patients with high self-efficacy tend to believe they can influence their health outcomes positively through their actions. They are more likely to feel confident in their ability to perform the necessary tasks associated with PD, such as maintaining sterility during exchanges, recognizing signs of infection, and managing their diet and fluid intake. This confidence can lead to better adherence to their dialysis regimen, resulting in improved health outcomes.

Moreover, self-efficacy can also influence how patients cope with the psychological challenges associated with PD. Living with a chronic illness can be emotionally taxing, leading to feelings of stress, anxiety, and depression. However, patients with high self-efficacy are often more resilient. They believe in their ability to overcome challenges and are more likely to use effective coping strategies, contributing to better mental health and overall quality of life.

So, how can we foster self-efficacy in PD patients?

Education: Providing comprehensive education about PD can help patients understand their treatment better and feel more confident in their ability to manage it. This includes teaching them about the mechanics of PD, potential complications, and how to respond to them.
Skills Training: Practical training in the tasks required for PD, such as performing exchanges and monitoring for signs of infection, can enhance patients’ confidence in their abilities.
Positive Feedback: Encouragement and positive feedback from healthcare providers can reinforce patients’ belief in their abilities. Celebrating small victories and progress can boost their confidence.
Peer Support: Connecting with other PD patients can provide a sense of community and shared understanding. Hearing about others’ experiences and successes can inspire confidence and motivation.
Goal Setting: Setting and achieving small, manageable goals can build self-efficacy over time. As patients see themselves successfully managing their PD, their confidence in their ability to do so will grow.

In conclusion, self-efficacy is a powerful psychological tool that can significantly impact the success of peritoneal dialysis treatment. By understanding and fostering self-efficacy, we can support PD patients in managing their treatment effectively, leading to better health outcomes and improved quality of life.

Of interest is how we go about ascertaining the degree of self-efficacy a person has and/or displays.

Self-efficacy is typically measured using self-report questionnaires. These questionnaires ask individuals to rate their confidence in their ability to perform specific tasks or behaviors. Here are some methodologies commonly used to measure self-efficacy:

General Self-Efficacy Scale (GSES): This is a 10-item scale designed to assess a person’s belief in their ability to handle a variety of difficult demands in life. Each item is rated on a 4-point scale.
Self-Efficacy for Managing Chronic Disease 6-Item Scale: This scale is specifically designed to assess self-efficacy in individuals with chronic diseases. It asks individuals to rate their confidence in doing certain activities, such as managing symptoms, following a treatment plan, and dealing with the emotional challenges of chronic disease.
Perceived Health Competence Scale (PHCS): This 8-item scale measures individuals’ beliefs in their ability to effectively manage their health outcomes.
Bandura’s Guide for Constructing Self-Efficacy Scales: Albert Bandura, the psychologist who first introduced the concept of self-efficacy, has provided guidelines for constructing self-efficacy scales. These guidelines suggest that self-efficacy scales should be tailored to the specific domain being assessed. For example, a self-efficacy scale for peritoneal dialysis might ask individuals to rate their confidence in their ability to perform specific tasks related to their dialysis treatment.
Disease-Specific Self-Efficacy Scales: There are also many disease-specific self-efficacy scales, such as the Arthritis Self-Efficacy Scale, the Diabetes Management Self-Efficacy Scale, and the Asthma Self-Efficacy Scale. These scales could be adapted for use with peritoneal dialysis patients.

It’s important to note that while self-report questionnaires are a common method for measuring self-efficacy, they do rely on individuals’ self-perceptions, which can be influenced by a variety of factors. Therefore, they should be used as part of a broader assessment strategy.

Sexual Frustration not Guns Kill

June 16, 2023 / Henry Feeser / 0 Comments

In the 6/5/2023 issue of PsyPOST Erich W. Dolan wrote an article titled “New study identifies sexual frustration as a significant factor in mass shootings.” I have never seen or heard of this before and although it’s off-topic for a dialysis-directed blog, it certainly is topical and very much in today’s news. The original article is linked here. I’ve included a summary below. It certainly blows holes in the theory that guns kill people.

A study published in Homicide Studies found that mass shooters exhibiting signs of sexual frustration were responsible for more victims on average than other mass shooters. This study highlights sexual frustration as a significant contributing factor to gun violence and notes differences in the psychological profiles and attack types of these individuals.
The researchers developed a set of criteria to identify sexually frustrated shooters, which included explicit complaints about sexual frustration, inability to find a partner, soliciting sex workers, stalking or harassing desired partners, and engaging in illegal or inappropriate sexual behaviors.
Approximately one-third of mass shooters were found to have sexual frustration problems. These individuals were six times more likely to have a history of sex offending, desired more fame, and tended to carry out some of the deadliest mass shootings in U.S. history.
Sexually frustrated mass shooters were more likely to be young, male, unmarried, childless, unemployed, and misogynistic. They exhibited behaviors linked to seeking relief, power, revenge, and displaced frustration. They also tended to kill more victims and a higher proportion of female victims, often choosing schools as their target locations.
The researchers argue that sexual frustration is a complex issue, not limited to virgins or “incels”, but also affects sexually active people. It is influenced by expectations, entitlements, and the embrace of toxic gender norms. They suggest that societal progress in reducing toxic factors, such as men’s assumptions that women are obliged to have sex with them, could help mitigate sexual frustration and, consequently, potentially violent behaviors.

The Big Two Plus Newbie in CKF Treatment: An Overview of the Competitive Space

June 15, 2023 / Henry Feeser / 1 Comment

The heavy half of the Cronic Kidney Failure treatment space consists of the big two, Fresenius Medical and DaVita, and a new entry, Strive Health, as the third. The discussion below is about the apparent strategies of these three.

Strive Health: A Progressive Approach to Kidney Care

Strive Health, a national leader in value-based kidney care, emerged on the scene in 2020 with a bold vision: to revolutionize the standard of kidney care, providing better access to care for individuals across socioeconomic backgrounds. The company has made impressive strides since its inception, now serving 80,000 chronic kidney disease (CKD) and end-stage kidney disease (ESKD) patients across 30 states and partnering with over 600 nephrology providers across 10 states.

Strive’s strategy centers on a value-based care approach that prioritizes patient outcomes over the volume of services provided. This approach aligns with the broader healthcare industry’s move towards value-based care, a trend also reflected in the strategies of Fresenius Medical Care and DaVita. Essentially, Strive’s strategy is to build sustainable partnerships with commercial and Medicare Advantage payors, Medicare, health systems, and physicians through flexible value-based payment arrangements, including risk-based programs.

Strive’s approach has led to a 20% reduction in the total cost of kidney care, a 42% reduction in hospitalizations, and a remarkable 94% overall patient satisfaction with Strive’s staff.

Fresenius Medical Care: Innovating for the Future of Renal Care

Fresenius Medical Care is another key player in the kidney care space. Its strategy is rooted in four core competencies: innovating products, operating outpatient facilities, standardizing medical procedures, and coordinating patients efficiently . In addition, Fresenius is leveraging digitalization, data analytics, and artificial intelligence to transform how it delivers healthcare, focusing on creating sustainable solutions with innovative products and services of the highest quality at a reliable cost.

Fresenius’ approach to renal care involves implementing new renal care models, promoting value-based care, integrating CKD and transplantation services, and fostering future innovations. These efforts are all part of their long-term commitment to sustainable development and growth.

DaVita: A Leader in Dialysis Care

DaVita is a leading provider of kidney care services, including dialysis. It is a company that is evolving care across the entire kidney care continuum—from early detection and management of chronic kidney disease (CKD) to optimal treatment for end-stage kidney disease (ESKD) and kidney transplant. They are working not only to improve their patient’s quality of life but also to transform the entire kidney care industry. They have a strong commitment to ESG (Environmental, Social and Governance) and have set 2025 goals

Comparing Strategies: A Focus on Value-Based Care

Comparing the strategies of these three companies, it’s clear that they all emphasize a shift towards value-based care, though they approach it in distinct ways. Strive Health focuses on technology-enabled care interventions and integration with local providers, while Fresenius Medical Care emphasizes innovation and the application of digital tools in creating new renal care models. Fresenius also seeks to expand value-based care programs to include chronic kidney disease and kidney transplants. DaVita appears to be competing on cost but is moving toward a value-added model.

While it’s clear that all three companies are invested in improving kidney care, they each bring their unique strengths and approaches to the table. It will be interesting to observe how their strategies evolve as they continue to strive for better patient outcomes in the changing landscape of kidney care.

Full disclosure: I own stock in both Fresenius Medical and DaVita. Srive is, at this time, a private company funded by investors such as NEA and CVS Health Ventures, and others. Strive now manages over $2.5 billion of annual medical spending and has grown to 550 employees, according to TechCrunch.

More about the CGM World

June 14, 2023 / Henry Feeser / 0 Comments

On May 26, 2023, in CNBC Tech Erin Black ran a story “How Dexcom and Abbott are moving beyond diabetes with blood sugar monitoring.” Since I am also a Type 2 diabetic and paying out of pocket for an Abbott Freestyle Libre 3 Continuous Glucose Monitoring system, this blurb was of interest to me. Watch the embedded video below for more insights into this growing market for CGMs.

Simple Tweak Improves Glucose Control

June 13, 2023 / Henry Feeser / 1 Comment

Writing in the May 31, 2023 issue of News Medical Life Sciences, Lily Ramsey LLM wrote an article titled ‘A simple tweak to first meal of the day may benefit people with Type 2 diabetes.” Since about 44% of those of us on dialysis also have been blessed with Type 2 diabetes, such a finding is of interest to us also. A link to the article is here. A summary of the article is below.

A study led by UBC Okanagan researchers suggests that people with Type 2 diabetes (T2D) can better control their blood sugar levels by modifying their breakfast to be low in carbs and high in protein and fats.
This single meal modification was found to help control blood sugar levels throughout the day, potentially limiting hyperglycemic swings.
The 12-week study involved 121 participants divided into two groups, one consuming a low-carb, high-protein, high-fat breakfast and the other consuming a traditional, high-carb, low-fat breakfast.
While there were no significant differences in weight, body mass index, or waist circumference between the groups, the low-carb group saw reduced blood sugar levels, and some participants could reduce their glucose-lowering medication.
Additionally, participants with a low-carb breakfast reported lower calorie and carbohydrate intake at lunch and for the rest of the day, suggesting that a low-carb breakfast could impact overall daily eating habits.

Attribution: Bing Illustrator for the lead graph, ChatGPT4 for summarizing the article, Grammarly for cleaning up after me, and me for the idea, concept, and any mistakes.

More on Tina Turner

June 12, 2023 / Henry Feeser / 0 Comments

I have previously blogged, soon after her death, about Tina Turner and her disregard for her high blood pressure, which was a contributing cause to her kidney failure and ultimate demise. Since that blog, more information about Tina has come to light, which is captured in the video embedded below. She certainly didn’t have it easy, and all of us can draw positive lessons from her will and tenacity in the face of adversity.