Energy Crisis

I am so glad that my workload is getting a bit easier. The long hours have been really stressful, and I am finding that it really has taken a toll on my health – physically and mentally. It’s not only work that has been taking my time, my other activities have been quite demanding as well. We have been preparing for our holiday show in my hula group, and the rehearsals, new material and costuming can be a lot of work.

Thank goodness my kidney is still in good shape. Through all this, I’d like to think that I am taking good care of it: drinking plenty of fluids, eating the right foods, and taking my medication on time. However, I do notice that my energy level is low, I am more irritable (ask Hubby) and can easily get stressed out.

At first, I was thinking that this is probably due to aging. I am getting older and perhaps I cannot pull the hours that I used to: work 45-50 hours per week, go to aikido class 3 times a week, hula class once a week, workout in between, and contribute my share in the housework.

As I think about it, I realized that this might be due to my compromised immune system. In my last doctor visit, the nurse practitioner did say that I will feel more tired because of my compromised immune system. Unfortunately, this is one of the tradeoffs I need to live with given the kidney transplant.

It does suck sometimes. Often times, I feel I have a lot of stuff that I need to do and so little time to do it. As much as my mind thinks that I can still do it, my body usually stops me and says “um…nap time”.

Some of it may be coming from my need to play catch up from the five years of dialysis and my feeling left out. I just have to remind myself that some of those can wait, and I need to prioritize. Others though are real: work deadlines, chores, studying for hula, and fulfilling my obligations at the dojo. Those I really need to work on.

What I usually do to fix this

Focus. To get something done, I just focus on one task. I used to be the queen of multitasking. Having two or three conversations via chat and working on two things. This was really tempting especially during the peak time of my work. That actually lasted for weeks, if not months.

By focusing, I am able to finish my projects with more quality and perhaps in less time. Besides, there is really no such thing as multitasking; you’re really splitting your attention in little time slices.

Napping. I did not use to take naps. I have way too much work to take that kind of a break. However, these days, I find that I sometimes need a quick 10-minute nap to recharge. That was a trick I learned from watching Dr. Oz. In Dr. Oz’s website, I read “in a NASA funded research, a siesta boosted performance of long haul pilots by 34%.” If it works for them, I suspect it will work for me too. Even in a smaller scale, anything will help. When I work from home, I sneak in a 10 minute nap at lunch so I can get through the afternoon. Otherwise, I sometimes would even take a nap after work to get me ready for the evening. Boy, sometimes I really needed it.

Dark Chocolate. Lately, I’ve been having a half an ounce of dark chocolate to provide a quick boost (Another little trick from Dr. Oz).  This is my favorite. Per Dr. Oz, dark chocolate is full of flavonoids that helps boost energy naturally… and it does work. I've tried it.

I think he recommends at least 72% cacao, but honestly, I find this percentage a bit too bitter. I settle for about 60%. Also, about an ounce is sufficient. Please don’t overdo it…regularly.

Also, if you are still in dialysis and watching your lab results, do monitor and see how the chocolate impacts your results. If I remember correctly, chocolate is a bit high on potassium (or was it my old nemesis, phosphorus). Do watch your sugar too if you are diabetic. I am not a nutritionist, so consult your dietician how much you can add to your diet. Fortunately, dark chocolate has less sugar and dairy.

Caffeine. Honestly, this has been my go-to choice for the past year. However, I am finding that I cannot have too much coffee anymore because it does give me abdominal discomfort. I wonder if this is a side effect of some of my medications (or just the age thing again). I try to stick to chai or green tea. Occasionally, I will still have coffee (because I do love it), but I consider it a treat.

I am hoping that in the longer term, my body can adjust and I will regain my previous youthful energy levels, or at least 80% of it. Perhaps in time, I will need less immunosuppressants, and I will have more energy. In the meantime, I’ll get rest… and have more chocolate. 

Side Effects

Image courtesy of Grant Cochrane/
FreeDigitalPhotos.net

I guess I spoke too soon about not having any side effects from my medications.

I have been seeing signs of side effects. My biggest concern is I am now extremely sensitive to salt. Every time we dine out, I gain at least two pounds. Before transplant, this did not happen to me (or so I would like to think). I could eat out at a restaurant or at the cafeteria, and not worry about bloating. These days, even at the end of the day, I can feel that I am retaining water. It can get so uncomfortable that I often have to wear loose pants (I cannot wait until it is warm enough that I can wear a skirt). If we get away for the weekend, forget it – It’s an automatic five pound swing.

I am not too concerned about the clothes. I like loose-fitting clothing anyways (except for the occasional skinny jeans). My primary concern is that the constant weight fluctuations cannot possibly be healthy for me.

I am also very tired in the morning and get really hit with a huge mid-afternoon slump. I used to think that this was not a big deal since a dose of caffeine usually puts me back on track. However, lately, I have been getting so tired that I cannot get up in the morning. Back when I was on dialysis, I felt that had more energy in the morning than now.

Fortunately, it can be fixed by a cup of coffee or chai. My lethargy when I was dialysis can last the entire day.

After my recent visit with my transplant nephrologist, I think we figured out part of the reason. One of my blood pressure medications – Minoxidil – is sensitive to sodium and therefore causing water-retention.  It may also be the culprit for my morning lethargy, but neither the doctor nor the nurse mentioned that the medication is causing that. Minoxidil does cause hair to grow in places where you do not want it (It is commonly known as Rogaine).

Unfortunately, now that it is a year after my transplant, my blood pressure medication is managed by my primary nephrologist. I now have three doctors: the transplant nephrologist, my primary nephrologist, and my primary care doctor. It really does make managing my medication a bit complicated. Don’t get me wrong, I am grateful for having so many doctors, each with their own specialty, managing my care.

I did e-mail my primary nephrologist to ask for his opinion – possibly lowering the dosage. However, all he did was prescribe a Lasix, a potent diuretic which I am a bit hesitant in taking. I had a bad experience with diuretics, and I really do not want to take one more pill. Perhaps we can present our case better when we meet him in person.

So in the meantime, I am taking some steps to minimize the side effects. We minimize dining out to reduce our sodium exposure. It still takes me 2-3 days to remove the weight that I gain when we eat out.

I am also allowing myself time to get up: I gradually sit up until my body is fully awake. So far, it seems to be working.

I guess we wait… until my next doctor visit.

What do you all think? Let me know; I am very interested in your input and feedback.