Medical Update

UPDATE:  Skin cancer is a risk for Scleroderma patients because most of us take immune suppressants.  I have Systemic Diffuse Scleroderma with symptoms beginning in Oct. 2007 but not diagnosed until March 30, 2009 and the skin cancers started in late 2010 with 4 of them in 2011. I had Squamous cancer on shoulder and Basal cell on face (right cheek) had MOHS surgery requiring 4 stages and a couple months later in May, had Squamous in vagina which came back in same area in 2012. Had a couple small Squamous removed from middle of back but in Nov. 2015, I thought I had Calcinosis above right eyebrow but PA ignored it and by April, another PA took a biopsy which was Squamous cancer which was removed on May 25, 2016 but within a couple months the bumps reappeared in same area, had biopsy and it was an aggressive Squamous cancer returned but I had complained about the soreness in my eyebrow for a year now. On Nov. 16, 2016 had MOHS surgery 4 stages with rogue cells breaking away from main tumor and spread out in all directions, after a traumatic 7 hrs. was sent home with open hole in forehead with no eyebrow and an error of margin along bottom of eye, doctor went on vacation after turning me over to a plastic surgeon to set up more removal of suspected tissue and for reconstructive surgery. It is 11 days and wound is still not repaired due to Thanksgiving holiday and all medical people took much deserved time off.  My wound is a good 2″ or more hole down to skull and entire right side and top of head feels like I have been in a car accident! Please, please protect your skin and see a dermatologist knowledgeable about Scleroderma. We are in shock that this happened because I have been diligently taking care to protect my skin and this could easily have taken my life. Angel hugs
Anemia is a condition in which the body has fewer red blood cells than normal. Red blood cells carry oxygen to tissues and organs throughout the body and enable them to use energy from food. With anemia, red blood cells carry less oxygen to tissues and organs—particularly the heart and brain—and those tissues and organs may not function as well as they should.
How is anemia related to chronic kidney disease?
Anemia commonly occurs in people with chronic kidney disease (CKD)—the permanent, partial loss of kidney function. Anemia might begin to develop in the early stages of CKD, when someone has 20 to 50 percent of normal kidney function. Anemia tends to worsen as CKD progresses. Most people who have total loss of kidney function, or kidney failure, have anemia.1 A person has kidney failure when he or she needs a kidney transplant or dialysis in order to live. The two forms of dialysis include hemodialysis and peritoneal dialysis. Hemodialysis uses a machine to circulate a person’s blood through a filter outside the body. Peritoneal dialysis uses the lining of the abdomen to filter blood inside the body.
What are the kidneys and what do they do?
The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine.
Healthy kidneys produce a hormone called erythropoietin (EPO). A hormone is a chemical produced by the body and released into the blood to help trigger or regulate particular body functions. EPO prompts the bone marrow to make red blood cells, which then carry oxygen throughout the body.
What causes anemia in chronic kidney disease?
When kidneys are diseased or damaged, they do not make enough EPO. As a result, the bone marrow makes fewer red blood cells, causing anemia. When blood has fewer red blood cells, it deprives the body of the oxygen it needs.
Other common causes of anemia in people with kidney disease include blood loss from hemodialysis and low levels of the following nutrients found in food:
•vitamin B12
•folic acid
These nutrients are necessary for red blood cells to make hemoglobin, the main oxygen-carrying protein in the red blood cells.
If treatments for kidney-related anemia do not help, the health care provider will look for other causes of anemia, including
•other problems with bone marrow
•inflammatory problems—such as arthritis, lupus, or inflammatory bowel disease—in which the body’s immune system attacks the body’s own cells and organs
•chronic infections such as diabetic ulcers
Healthy kidneys produce a hormone called EPO. EPO prompts the bone marrow to make red blood cells, which then carry oxygen throughout the body. When the kidneys are diseased or damaged, they do not make enough EPO. As a result, the bone marrow makes fewer red blood cells, causing anemia.
What are the signs and symptoms of anemia in someone with chronic kidney disease?
The signs and symptoms of anemia in someone with CKD may include
•fatigue, or feeling tired
•problems with concentration
•difficulty breathing or shortness of breath
•chest pain
Anyone having difficulty breathing or with shortness of breath should seek immediate medical care. Anyone who has chest pain should call 911.
What are the complications of anemia in someone with chronic kidney disease?
Heart problems are a complication of anemia and may include
•an irregular heartbeat or an unusually fast heartbeat, especially when exercising.
•the harmful enlargement of muscles in the heart.
•heart failure, which does not mean the heart suddenly stops working. Instead, heart failure is a long-lasting condition in which the heart can’t pump enough blood to meet the body’s needs.
To diagnose anemia, a health care provider may order a complete blood count, which measures the type and number of blood cells in the body. A blood test involves drawing a patient’s blood at a health care provider’s office or a commercial facility. A health care provider will carefully monitor the amount of hemoglobin in the patient’s blood, one of the measurements in a complete blood count.
If blood tests indicate kidney disease as the most likely cause of anemia, treatment can include injections of a genetically engineered form of EPO. A health care provider, often a nurse, injects the patient with EPO subcutaneously, or under the skin, as needed. Some patients learn how to inject the EPO themselves. Patients on hemodialysis may receive EPO intravenously during hemodialysis.
Studies have shown the use of EPO increases the chance of cardiovascular events, such as heart attack and stroke, in people with CKD. The health care provider will carefully review the medical history of the patient and determine if EPO is the best treatment for the patient’s anemia. Experts recommend using the lowest dose of EPO that will reduce the need for red blood cell transfusions. Additionally, health care providers should consider the use of EPO only when a patient’s hemoglobin level is below 10 g/dL. Health care providers should not use EPO to maintain a patient’s hemoglobin level above 11.5 g/dL.2 Patients who receive EPO should have regular blood tests to monitor their hemoglobin so the health care provider can adjust the EPO dose when the level is too high or too low.2 Health care providers should discuss the benefits and risks of EPO with their patients.
Red Blood Cell Transfusions
If a patient’s hemoglobin falls too low, a health care provider may prescribe a red blood cell transfusion. Transfusing red blood cells into the patient’s vein raises the percentage of the patient’s blood that consists of red blood cells, increasing the amount of oxygen available to the body.
Eating, Diet, and Nutrition
A health care provider may advise people with kidney disease who have anemia caused by iron, vitamin B12, or folic acid deficiencies to include sources of these nutrients in their diets. Some of these foods are high in sodium or phosphorus, which people with CKD should limit in their diet. Before making any dietary changes, people with CKD should talk with their health care provider or with a dietitian who specializes in helping people with kidney disease. A dietitian can help a person plan healthy meals.
Recommended Daily Value 18 mg 6 mcg 400 mcg
100 percent fortified breakfast cereal ¾ cup (1 oz) 18 mg 6 mcg 394 mcg
beans, baked 1 cup (8 oz) 8 mg 0 mcg 37 mcg
beef, ground 3 oz 2 mg 2 mcg 8 mcg
beef liver 3 oz 5 mg 67 mcg 211 mcg
clams, fried 4 oz 3 mg 1 mcg 66 mcg
spinach, boiled 1 cup (3 oz) 2 mg 0 mcg 115 mcg
spinach, fresh 1 cup (1 oz) 1 mg 0 mcg 58 mcg
trout 3 oz 0 mg 5 mcg 16 mcg
tuna, canned 3 oz 1 mg 1 mcg 2 mcg




1 Response to Medical Update

  1. Teressa Colosimo says:

    Great info:) I have been looking at a lot of websites, this site explains so much. There is so much great information. I can send this site to my family and they will get an understanding about this disease. Thank you, Teressa

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