“You may start to feel tired“…is what I was told 15 years ago when I began this journey with chronic kidney disease. Anemia and fatigue have been the biggest challenge I have faced. It went far beyond “feeling tired” though there where days when I could barely lift my head from the pillow. Anemia happens when your red blood cells are in short supply. Red blood cells carry oxygen from your lungs to all parts of your body, giving you the energy you need for your daily activities.
Symptoms of Anemia include:
1. Looking pale
2. Shortness of breath
3. Trouble sleeping
AND
4. Feeling dizzy and having headaches
I can remember the very first time I felt these symptoms. I was vacationing on Cape Cod and had spent the day at the beach. After hours in the sun I had to climb up the steep dunes to get back to our car. About half way up I felt so exhausted that I just dropped everything I was carrying and fell to my knees. I hadn’t ever recalled feeling that way. It wasn’t until I returned home and went back to my kidney doctor that I found out what was going on.
I later learned that one of the functions of your kidneys is to make a hormone called EPO. Hormones are secretions that your body makes to help your body work properly and keep you healthy. EPO tells your body to make new red blood cells. When you have kidney disease, your kidneys cannot make enough and this causes your red blood cell count to drop and that’s when you develop anemia.
Most people with kidney disease will develop anemia. Anemia can happen early in the course of kidney disease and grows worse as the kidneys lose their ability to work well and make EPO. Anemia is especially common if you:
1. Have diabetes
2. In stages 3,4, or 5 of kidney disease
AND
3. Are female
But because not everyone with anemia gets symptoms you should have regular blood tests to measure your hemoglobin levels.
Hemoglobin is the part of the red blood cell that carriers oxygen throughout the body. Your doctor can tell if you have anemia by measuring your hemoglobin levels. If your hemoglobin levels are below normal which is 12.0 for women and 13.5 for men. Your doctor will start a treatment plan to raise your hemoglobin. This usually includes drugs that work as an EPO stimulate. These agents are called ESA’s and helps your body to make new red blood cells that your kidneys cannot. It is usually given as an injection under the skin and most CKD patients learn to do this at home as self injections.
The other treatment part of anemia is controlling your iron stores. Your body needs iron to make red blood cells especially when you are receiving an ESA treatment. Without enough iron, your treatments will not work as well. Iron can be given either in pill form or through IV. Your iron stores should be at least 20% and should be checked along with your hemoglobin levels.
Your doctor will check your hemoglobin levels on a monthly basis to bi~monthly basis. This tells your doctor how well your doing and your dose of the ESA will may need to be changed, depending on how well you respond.
If untreated, anemia can make your health conditions worse and cause your heart to work harder.
So what did I do about this? When it appeared that I would be dealing with anemia and fatigue for a long time.
1. Started a log of my symptoms so when I returned to my kidney doctor I could give her specifics details on how I was feeling.
2. I embraced the way I was feeling and realized it was a symptom of my disease.
3. When I was started on Procrit which was my ESA, I was certain to follow my doctors instructions to the letter.
4. I allowed myself something called "PJ days" and got the rest I needed when I needed it.
5. I began working with my dietitian to include iron rich, kidney friendly foods.
And last but not least
6. I stayed as active as I could adding in exercise when possible.
Although anemia and fatigue are unavoidable in Chronic kidney disease there are steps you can take to limit the impact on your every day life. Just knowing what to look for and being prepared is half the battle. Keeping up on your ESA, having your hemoglobin and iron levels checked and recognizing the symptoms will go a long way in controlling these. Whether your newly diagnosed or have been dealing with CKD for a long time anemia and fatigue will be part of your life so prepare yourself now even if your doctor has not.
I want to thank you for joining me on this journey, I look forward to your comments, questions and concerns.
Keep on fighting all you Kidney Warriors.
~Kidney Blogger
Great presentation, Dena ! Both here in writing and yesterday in person - I think people learned a LOT about how to live a good life even with kidney disease, and how to be knowledgeable and in charge of their health care team. :)
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