Planning for Adventure

I have not been blogging much lately, primarily because I’ve been working, working, working. Since I’ve mostly been blogging about how busy I have been, I decided to do something about it.

Craving to travel again...hopefully somewhere warm.

Actually I’ve been forced to take time off since I am maxing out on my accrued time-off: I already got to the point of “use it or lose it” – so I am trying to use it as much as possible. However, this had been only days off here and there and often only sufficient time to catch up with chores.

We’ve also been planning on an extended vacation. This is after five years of dialysis. Don’t get me wrong. Although, we enjoyed mini three- or four-day breaks here and there, but it’s not quite the same since there was not enough time to truly recharge.

This will also be the first vacation where we don’t have to plan dialysis time. So, all the time would be R&R. Also, when I was in dialysis, we limited out vacation to the United States only, to minimize dialysis costs (our insurance still pays for it). For the first time, we can consider an international vacation.

At first, I thought that it would be like old times: plan the trip, pack and go (pay for it later). However, travelling with a kidney transplant presents some new challenges for me.

How to bring my medicine? For an extended vacation, I would need to bring a lot of medication – at least enough to cover the days when we are gone – maybe more for back-up. I was originally thinking of packing half in my weekly container and extras in another container. However, I was told that it may be better to pack them in their original containers: it would better chance of passing security and not getting confiscated.

I would probably also put them in my carry-on so there is less opportunity to get them lost. I can pack two sets and have the other one with my husband… again, in case things get misplaced.

When to take my medicine?  Since there are time zones involved when travelling, it can be challenging if the time difference is more than 3 hours. That means that I may need to take my regular medication in the wee hours of morning.

In my last doctor’s visit, I had the opportunity to ask my advice nurse about this dilemma. She suggested that I adjust my medication times before the trip, maybe in 30 minute increments, until I get to my desired time. Then, do the reverse when I get back.

Food Safety. All the food safety rules still apply, even when on vacation. That means washing fruits – with clean water. No buffets. Ensure that your food was prepared in a very safe manner. To be on the safe side, I may bring a lot of granola or protein bars. That will at least ensure that I have something to eat during the day.

I am also concerned on how to let my family know about my limitations. They have not seen me in a while. I feel my diet is quite strict and I am not sure how other people will adjust.

Water Hygiene. Another factor to consider is safe water. Although I still need to hydrate, hydrate, hydrate, there are many parts of the world where water may be a bit iffy to drink. For me, that may mean only bottled water. Filtered water (with my own filters) may be okay too. I need to check with the nutritionists.

We’re really excited about travelling again. It has been too long since we’ve explored other cultures and see the wonders of the world. We are really looking forward to it.

A Test of Endurance

Blogger’s Note: One of the main reasons that I continue to blog is to share how my life is after the kidney transplant. After transplant, I expected to be able to do EVERYTHING that I used to do and "with much more gusto".

While it has been over a year and a half, I still am getting used to moving with my new kidney. I think part of it is that I choose to continue with activities that require me to adjust my movement - primarily martial arts. I have not even resumed my water activities, so hopefully we will soon see how that is affected. 

Also, I recently learned that because of my lowered immune system, I would get tired more (Thanks Dr. Oz), which is probably why I cannot do as much as used to do before dialysis "with gusto".

Plus, I am getting older. Anyways, here goes…

Last weekend (23rd through 25th of August) was a great aikido weekend in the San Francisco Bay Area. Our division headquarters, Aikido of San Leandro celebrated their 30^th anniversary. It was a big deal: yudanshas (black belts) who have been training forever attended the celebration, high ranking teachers demonstrated, and long parties afterwards. It was a long but enjoyable weekend.

However, I knew that weekend would be a challenge to my energy level: we started training Friday night, then prepare for the long day of training and demonstrations on Saturday, then the potluck afterwards, and then Sunday’s All-Division training all the way to the other side of the bay (about an hour’s drive away… maybe an hour and a half). To add to that, we had a special guest instructor Monday evening, arranged by our sensei Sunday afternoon, so I knew I had to update our website and also attend class Monday night.

I had to plan. I was just going to leave work early on Friday, go and train, and rest for Saturday. However, the potluck was going to be an issue: for big events like this, I usually bring something homemade, but would keep until after two hours of training and two or more hours of demonstrations – usually something baked and sweet or a huge salad. I can still do it given my schedule, but I would not be getting enough rest – and I knew I would need it. I am still working outrageous hours at work and if I don’t give time to relax, I know there is little chance of my surviving the weekend.

What to do…

Compromise.

I decided not to bring something homemade this time. Although I opted for something store-bought, I went for something unique. Since students from all over the world would be coming to the party, I decided that sharing something from my heritage would be good. I brought Filipino rice cakes: different types. That way, I can try out what rice cake works. It's been my goal to learn how to make those cakes at home anyway, so this can be counted as "research".

I also took Friday off: I did not know how late class was going to be on Friday night so I decided to take it easy during the day, in the event that it will be a late night. Friday was dedicated to relaxation: no meetings, no work, no assignments… just rest, perhaps do something enjoyable, and prepare for the weekend.

During the weekend, I made sure I had plenty of rest and nourishment. I started the day with a really good but quick breakfast: usually a bagel with “the works”: tomatoes, cream cheese, and avocado (I know, potassium and phosphorus nightmare – but I can have it now, and it does fuel me for the day).

Saturday is usually a long day and lunch is not until 3 or 4 pm. I brought a good supply of provisions: nuts, kind bars, bread, and plenty of water, just in case. This was a good strategy since I cannot really enjoy the potluck; it’s almost like a buffet especially with that many people.

I used the same strategy on Sunday. The best thing about Sunday is that it’s a shorter day. Carpooling helped me conserve energy and saved a bit of carbon footprint.

Overall, four days of training was exhausting but rewarding. Not only did I get back in touch with old friends, but connected with my friends at our dojo. Since I carpooled two out of four days: We were able to share ideas, laughs, and stories. Carpooling became a great time to share and know each other better.

As I told my Sensei, it was a sensory and information overload. It was a very memorable experience. Because I was able to rest, I felt I was able to get the most of the event.

Now, it’s time to digest it all….

Lessons in Paranoia

Image courtesy of Stuart Miles | FreeDigitalPhotos.net

An unintended consequence of my kidney transplant is my extreme protectiveness over my new kidney. In the process of protecting my kidney, I do my best to avoid hits, falls, or any sort of trauma on my right abdominal side.

This is fine when I can control the situation; however, when it is by accident or absent-mindedness; I often (for lack of a better word) freak out. As an example, my car was rear-ended recently, and I was overly concerned that the pressure from my seatbelt might hurt my kidney. There were other similar situations that lead to concern and stress, but they turned out okay.

I have never been like that before. As an example, even before the transplant, I have been slightly afraid of heights, but I learned how to ski and have been up on many summit runs. I have been also afraid of closed spaces, but have gone inside and down a cavern or two (I did get sweaty cold hands walking down … and I wanted to rappel!). Also, I have learned and enjoyed diving (with my hubby) in many places in the world.

Now every bump, nudge, hit – I feel paranoid. Even in dining, I am not as adventurous. If I encounter a new dish or ingredient, I immediately think "is that on my approved list?"

Could it be that it is a side effect of my medication? Possible. Through my (very limited) reading, I learned that taking prednisone or other steroids could cause paranoia. Other posts say that it is extended stays in ICU. However, I am not taking steroids and my hospital stay was only five days, and spent most of the time in my own room. 

It’s still a possibility, but unlikely.

I also think it is partially because when I was in dialysis, I have been continually warned that when I did get a transplant, I could not get hit around my transplant spot since the new kidney is not protected by my rib cage (The new kidney is placed in the front, near my belly-button). I have heard that repeatedly from the nurses, the charge nurses, and the doctors. Because of this, I was concerned enough that I even considered not getting a transplant and just remain on dialysis. If one is an active person, like me, how can one avoid not getting hit? I can not ski, windsurf, and do martial arts? 

I am trying to remedy that by adding activities one by one. I am back in aikido and we just recently went on a ski trip (and hopefully, going on a second one). Sadly, I do not think windsurfing is a possibility anymore: too many opportunities for falls. One time, admittedly, I was going fast on my board and fell... Boy, that water felt like concrete.

Anyway, I digress... again.

As I am writing this, I am realizing that it is perhaps also from my fear of my disappointing anyone. I have always wanted to exceed everyone’s (including mine) expectations, perhaps sometimes to my detriment. I have been raised to work very hard and always be the best. As a result, I have always worked long hours and played my best – really burning the candle at both ends. Losing this kidney would be a huge disappointment to me, my husband, the care managers, and to my family.

I do not know.

I really do need to figure out how to get over this. I cannot constantly live in fear. As I've said, I want to live my life to the fullest, and living constantly paranoid would not allow me to do that.

Admittedly, writing this post was a good exercise in identifying possible causes and probably a good first step to combat it. Continuing to be mindful and careful, taking things slow, and perhaps going back to basics until I am comfortable with my new situation should also help.

If you have any suggestions, please let me know. I would really appreciate it!

Snow Day

For President’s Day Weekend, we planned to do a one-day ski trip to Lake Tahoe. We had a much-needed storm the weekend prior, and another one was forthcoming.

It was the perfect time. It was our first time back skiing in two years. Two years ago, the snow did not come and my Hubby had a damaged knee (from skiing down some advanced runs at Kirkwood), and last year, well - we all know what happened then (I had a kidney transplant).

I think I was a bit more anxious for this trip; not only because it has been awhile, but primarily, because I really had to be careful. I have to take care of my kidney while skiing; so, I have to be even more mindful of what is around me and the snow conditions; With my new kidney, I felt like one of the Slope Style skiers in the Winter Olympics at Sochi, Swedish skier Henrik Harlaut. He was inspired by the movie “Cool Runnings” and carried a lucky egg with him in his event. Instead of an egg, I have a very lucky kidney. I cannot have it break. (In case you missed it, we speculated that Henrik broke his egg after a nasty spill). I cannot have hard falls – especially on my right side.

When I am practicing aikido. I can more or less control what I do. However, I cannot control the people around me and I have to be 10 times more mindful when doing partner practice. While skiing and I have to be 100 times more aware. Also, I have to say goodbye to skiing fast. When I go fast, I have less time to react when something wrong happens. I remember that my skis are fast. The first time I used them, I could not believe how fast they wanted to go, and I had to accept and get used to the speed. Now, I have to do the opposite, and figure out how to control my speed.  On the slopes, Hubby and I started slow.  It was a great day though with blue skies and the slopes were still in great shape – groomed packed powder.

It felt good to be in the mountains and be outdoors. As we did our first run, the snow really felt good under my skis. I had good control of my skis, took easy, slow turns, and skied down the slope. It did not feel like I missed two years. Although we agreed to only do easy green runs, we stretched ourselves and tried a blue intermediate run before lunch. Most of the ski runs at Alpine Meadows are really advanced, i.e., even the blue runs are difficult, so, I opted to try an easy blue! I just took extra care and was able to complete my run – and another!

In fact, the trail conditions in the morning were so good (and the slopes were not crowded) that, I even put on the gas, and a few times when the slopes were nearly empty. It really felt good to be back on the mountains and ski! Being outdoors and feeling the fresh air felt great, and it reminded me why I love skiing. It gives me the opportunity to commune with the mountains and nature at its winter best and, also have fun at the same time. This ski trip made all the sacrifices of the past year worth it.

AWESOME DAY! SO STOKED!

One Year Later

January has always been a special month for me. It is the start of a new year and has always symbolizes new beginnings. Last year, it became extra-special since it was also the month when I had my kidney transplant. I cannot believe that it has been a year already.

I have been looking through my posts after the transplant and realized that I have come a long way. At that time, I could not walk without pain medication. Most of my days were spent sleeping. There were days when I would take four tablets of really strong pain meds. Now, I am walking, going to aikido class regularly, and dancing hula. I am even considering going back to the pool to prepare for our upcoming vacation (because it will hopefully be in somewhere tropical). The only time I take pain medication is when I overdo some of these activities.

It's not that everything is back to normal. I do miss some things that I can no longer enjoy because of my revised diet. I’ve always thought that I would never be pregnant, but now I am eating as if I were a pregnant lady – avoiding bacteria and raw food. At least, I can have some caffeine and wine.

I also still experience some sleepiness in the afternoon, probably due to one of my medications – most likely the blood pressure pills or even the immunosuppresants. But I still think I am very lucky: some transplant recipients experience numerous side effects to their new medications. Mine can be fixed with a latte or some chai.

We also had some scares along the way.  I have been hit twice accidentally in my kidney spot and recently got into a car accident. In each of those, I got very shaken up and felt extremely paranoid – sometimes paranoid to the point that I would prefer to stay home and be safe.  After some contemplation and introspection, these incidents did help me reset and give me new perspective. I do need to be even more careful and mindful.

I am really appreciative of those in my support system without whom I would not be able to make it through this year. The nurses, the doctors, and my friends – close and far away have made my recovery easier to manage. Most importantly, I am very thankful for my husband who has been by my side every day. Oh, let’s not forget my little angel – Meow, who also has been giving me emotional support and company.

This past year has been interesting, adjusting to my new situation and routine. I do intend to experience life to the fullest and not to be afraid of new adventures, as long as I continue to be mindful and careful. 

After all, isn’t that the point of being given a new chance in life?

The Diva Diet - Part III: Odds and Ends

This is my last installment of The Diva Diet – or what I call my post-kidney transplant diet. This one focuses on general, but important stuff.

As you read through these posts, please remember that this is what works for me.  Everyone is different.  You may need to adapt it for yourself and for the meds that you are taking.

Balanced Diet?

Maintain a balanced diet. For my meals, I try to adhere the Choose My Plate guidelines: combining protein, grains, and a good focus on vegetables. Although I am sometimes not successful, I usually try to add veggies with my meal – some of them pretty hidden (I don’t like peppers that much).

Also, as I mentioned in a previous post, I can now add whole wheat and other grains in my diet. Since I do not have any phosphorus restrictions, I can now experiment with different grains. When I was in dialysis, I was pretty much limited to white rice and white bread, which probably created havoc with my digestive system. Now, I can have quinoa, barley, corn meal, oats (my favorite) and oat bran.

I still need to be careful though; immunosuppressants may increase potassium in one's system so you may need to watch high-potassium foods like bananas, mangoes. and coconut. If this is the case, moderate your potassium a bit – just like when you were in dialysis. My guilty pleasure is usually bananas or mangoes. I’ll have only a third of a banana in my cereal and about third of a mango.

Key is everything in moderation. My meals are usually 4-5 ounces of protein, whole grains (I still have a bit of white rice added for flavor), and lots or veggies. I try to practice Meatless Mondays or just have Meatless lunches. Actually, when I have a meatless lunch, I am more alert in the afternoon and don’t get that 2:30 slump.

When in doubt, ask your nutritionist. Since I've been experimenting on different foods, sometimes, I find things that may be iffy. A few recent examples are celery seed (as a replacement for salt) and wakame salad (seaweed salad). I usually start with my own research, but if I don't find any relevant information, I consult with my transplant coordinator or my nutritionist. They are the experts on this, not me.

Keep moving.  This means what you think it means: exercise. I find that when I walk, my body (and mind) is able to function more efficiently. I make it a point to exercise at least 20-30 minutes at least five days a week.

Me in aikido class - one of my favorite activities

Do vary it. Example, I practice a martial art called aikido, practice hula dancing, and do regular cardio like walking or doing the elliptical. I am trying to incorporate stretches and core strengthening exercises, but I feel at this point cardiovascular exercises are more important in maintaining a good blood pressure.

Be cautious not to overdo it – and believe me, I have. While it is important to move, again do it in moderation and consult your doctor before you start a new routine. I have to keep reminding myself that my surgery was not too long ago. Rest and recovery are still equally important.

Keep hydrated. My new kidney needs to be constantly hydrated, so I need to drink plenty of water. Actually, everytime I see the word “hydrate”, “drink”, or “water”, I drink some water. I guess it’s my version of a drinking game.

I believe hydration is key in keeping your creatinine low. Now, that it’s winter, like me, you probably don’t want to drink water, but continue on hydrating. Choose low-caffeine or herbal teas. Soups are okay too, I think – just be cautious of the sodium content.

 

I try to keep these tips in mind everyday. Although some of these we really need to adhere to (like food safety), the ones that are optional, I try not too obsess over (too much). It’s the holidays, and it is time to celebrate with family and friends. I plan to relax, be careful, and enjoy my new kidney.

Bon Appetit!

You might also enjoy:

The Diva Diet - Dining In

The Diva Diet - Dining Out

The Diva Diet - Part II: Dining Out

Now that Thanksgiving is over, as always, most of the challenge in sticking to your diet when eating out: office parties, group parties, get-togethers with visiting friends or relatives, etc… The list is endless.

As a kidney transplant recipient, I still have restrictions, but there is no reason why I cannot enjoy these holiday get-togethers. Here are my ideas for keeping your diet during the holiday season while dining out.

Be Mindful of Food Safety When Dining Out. As I mentioned in a previous post, we need to continue to be careful of infection, from all sorts of germs or bacteria. I can understand why this is a concern. After watching shows like Kitchen Nightmares and Restaurant Impossible, we have seen problematic kitchens and food gone bad that were still served to the public. All of us need to ensure that the establishment has passed health safety guidelines and that the food is stored and prepared well in a very sanitary way. Since my transplant, my husband and I have been very picky in selecting restaurants when we eat out. We often limit ourselves to nice, very nice restaurants, but this can get expensive.

 

No Buffets. This is a follow-up to the food safety issue. With buffets, the food has been exposed to different people, so you never know who touched what or what temperature it has been kept. With food exposed to different people, you never know what germs they may carry. Again, after watching Restaurant Impossible and seeing buffets that were not kept at the correct temperature, I can understand why this continues to be a concern.  Served Hors d’Ouevres are out now too: same principle as buffets, except now your food is traveling.

Cafeteria-style food may be okay. Assess the situation and figure out if this option is safe. Do not be tempted by really yummy food – your life is more important. An alternative may be to wait until you get home and just simply nuke it.

Order your own entrée. As I mentioned before, when dining out, meals really need to be made for me only – Hence, the name “Diva Diet”. If it is just my husband and I, we usually share an appetizer and an entrée, but we move it to separate plates. When we go with a group, I would stick to my own dish.

Family-style food may be okay, as long as they use serving spoons, AND no one is sick.

No raw meats or eggs. Unfortunately, that includes raw sushi and oysters – my old favorites. Again, it’s a question of bacteria. So, I must say goodbye to my beloved salmon rolls, ahi pokes, oysters-on-the-half-shell, and tuna tartars. Even smoked foods like salmon are also out of the question. Sigh, at least, I think, I can still have cooked sushi (ebi and unagi anyone?) and usually there are other items on the menu.

Be careful of raw eggs too. This may mean aioli, Caesar salad dressings, certain meringues (baked meringues are probably fine), and eggnog! No more eggnog lattes. The only raw thing that would be safe would be fruits and vegetables.

Deli Sandwiches. Improperly reheated cold cuts and soft cheeses can contain certain bacteria that can cause illness and possibly death to a kidney transplant patient. That means no more cold cuts, or for that matter cold, deli sandwiches. Also, the coleslaws and potato salads are probably not a good idea either. Some possible alternatives: hot sandwiches or a bagel and cream cheese … and get them from a high-end deli.

Craving for Tacos? Make it yourself.

A word on fast food. I do not normally eat fast food, but a sucker for some of them, especially tacos or hash browns. I think occasionally it’s okay: I am going to limit myself to maybe once a quarter. Surprisingly, since I’ve been eating fresh food and whole grains, I do not have any craving for fast food anymore, except for tacos and hash browns.

Limit dining out. I’ve noticed that every time I eat out, I gain at least two pounds. To make the food really-really yummy, most chefs season their food rather well. Most of the weight that I gain is from water retention and it impacts my blood pressure. Can you imagine what happens when I eat out all the time? My blood pressure can go through the roof. If you can limit dining out, you can give your body a chance to get rid of the excess water.

Again, Do have fun! As a former dialysis patient, I have memories of food restrictions and evaluating how many binders to take if you had some pizza. Yay! Gone are those days. So even if you do have restrictions, try new places and new types of food. As an example, for Oktoberfest, we found a German restaurant nearby that was just awesome. My husband said it was just like what his Dad made. They gave us gigantic portions: so my husband halved the entrée and still had a full meal, and with a to-go box!

The key is to enjoy your new life while still keeping safe. As an old saying goes - “Life is to be enjoyed, not endured.”


Final installment: Other important stuff.