A while ago, like over 15 years ago, I had some lab work done, and was called into my then Family Doctor to discuss the results.
I go in and sit down, or something like that, and we go through the results.
A1C - Check
Fasting Blood Glucose - Check
Lipids - Check
and then.............
Oh, you have some protein in your urine.
My heart dropped, to me this meant the end all be all, downward spiral into one of the killers that diabetics get, Kidney Failure.
I replied "Really, what does this mean?"
He said, "It is called Microalbuminuria and it is a very early indication of Kidney Damage."
I said, "So my kidneys are damaged?"
He said, "Well, not exactly."
I thought, WTF I'm really freaking out here, and you can't give me a straight answer. I was a hot head back then. But I did not vocalize my thoughts.
I said "What can we do?"
He said "We will put you on an ACE Inhibitor, which is a low dose Blood Pressure Medication that works on the kidneys and prevent the progression of Kidney Damage"
I took my first breath of relief. Took the Rx and filled it immediately.
This was my first encounter with a potential deadly diabetic complication. And I was completely freaked out about it. I spent the next several weeks, researching Kidney Disease, Progression from MicroAlbuminuria to overt Proteinuria. I looked to basically see how long I had left to live.
I guess the lesson I learned from this is that people get panicked about results, so when I break the news I do the best I can to provide as much information as possible and also offer a feedback loop, so the patient does feel on their own.
I never ever want anybody to feel like they have had a brush with death in the doctors office.
Trev
4 comments:
If you think it can be reversed, you are ignorant.
If you think kidney damage can be controlled or reversed you are ignorant.
Thanks for this post, Trev. I read with interest, as I've been told and have gone through the same thing - currently on ACE inhibitors as I've been for a few years now. My most recent Endo visit post-Lab work revealed some higher levels of protein (more steak??) but we didn't make any changes. James, as you seem to be very concerned about "reversing kidney damage," I'd offer what I have come to understand from various doctors and research: that complications can be slowed down by better BG control. That if it's not progressed all too much, the body can sometimes help itself if said BGs are better-controlled and it might not go into full-fledged kidney damage/failure. Obviously, no one here pretends to be a medical professional so consult with yours appropriately. I wish you and everyone the best if these issues surface, but I do like to hear real-life examples of how people respond to these things. Trev, I'd be interested in hearing more on what came to be from all that and where you stand at this point. Thanks for writing this, my friend.
I've had a few random protein checks come up positive in the last 15 years, only to have everything come back completely normal with a 24hr collection. After the very first time I tested positive for protein, the doc suggested an ACE inhibitor, but I refused. My average blood pressure is low-normal, and even if the side effects were mild, I would likely experience frequent fainting or dizziness. It's just not worth it at this point, especially since I don't have established kidney damage or consistent proteinuria. I do have to admit that the second time I was told that I had some protein was a little frightening, especially since it was when I was pregnant with my first child. It turned out to be nothing to worry about after I got back the 24hr collection results, but it was still alarming given the situation.
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