On the Mountain of Healthiness, We're *HERE* - CKD Update February 2025

After rescheduling his January appointment, we met with Dr. L today. On our way there, as we were parking in the parking garage, I told him that if he wanted to quit and never have a biopsy, and never see Dr. L again, I would accept that decision. His October visit was very stressful, and he seemed just so... DONE... with everything. Personally, if it were me, I'd keep going until I could figure out what was wrong and how I could fix it. But he's not like that. He gets frustrated and overwhelmed and just flips a table and walks away. So, I put the ball in his court and said, if you quit, I stand behind you. 

Speaking to Dr. L, he had to admit that we've done pretty much nothing healthy over the holidays... Between Thanksgiving and New Year's, life just sucked. Clover got sick and passed away, and we just said fuck it and didn't give a shit about anything. We ate a lot of junk food, a lot of fast food for dinner, a lot of prepared food (like chicken nuggets or frozen pizza) for dinner... Neither of us could be bothered to do anything good for us! He stopped taking his meds and doing blood pressure checks. Thankfully, we got our shit together again after New Year's, which is why we rescheduled his appointment. 

She reviewed his numbers, which seemed to be wavering slightly, but not decreasing too much; his eGFR is up to 69 (nice) and most other numbers are holding. His blood pressure, of course, was much worse than it had been, but that's because he stopped taking his meds. His A1C is just a tiny bit higher than she'd like (normal is 5.6% and he's at 5.9%), so we need to keep an eye on that in future visits now, too. She stressed again the importance of staying hydrated, eating right, and exercising. I told her that we were doing better in that regard, though we weren't where she wanted us to be. I gave her a visual of a tall mountain and a low valley; she was down in the valley, demanding we come down to be healthy with her, and we were up near the top of the mountain, where it was super-unhealthy and full of Bad Things. We were slowly coming down to meet her, but still far away. We explained that there was progress being made, but because we were so high up on the mountain, it would take us a while to get down to her level. She seemed content with that, because she understood that there was forward motion, no matter how slow. 

We told her about the gastro issues and the chest pain; she suggested that the chest pain may actually be Costochondritis, inflammation in the costosternal cartilage that connects the ribs to the sternum. It most commonly affects the upper ribs on the left-hand side of the body, and pain is often worst where the rib cartilage attaches to the sternum, but can also occur where the cartilage attaches to the rib. It's also known as Chest Wall Pain Syndrome or Costosternal Condrodynia. The cause of Costochondritis is unclear... Treatment focuses on easing the pain while waiting for the condition to ease on its own, which may take several weeks. Symptoms include sharp, aching, or pressure-like pain, pain that may radiate to the arm or shoulder, and pain that worsens when taking a deep breath, coughing, sneezing, laughing, or any other chest wall movement. Interestingly, Costochondritis occurs most often in women over 40, so I wonder if this is something that I'll have to deal with at some point? 

Because of the inflammation, she wondered again about an autoimmune disease - something she's never been able to rule out as a factor for him. He had an abnormal antibody test back in June, which hints at an Autoimmune disease, but doesn't point to anything specific, unfortunately (it's not HIV or AIDS, we tested for that). For now, she'll take another wait and see approach while he works on getting his blood pressure back under control (it was 143/89 at this visit). 

She brought up the subject of a kidney biopsy again, but surprisingly, Hubby didn't automatically shut down. He wasn't happy to talk about it, but he seemed a little more open to the idea? She didn't push it though, because she won't do it until his blood pressure is back to normal (which would be around 120/80). To that end, she upped one of his blood pressure meds, reminded him to do blood pressure checks routinely, then asked us to come back in April. I looked over at him, thinking that this would be the time for him to shut it down or keep it going, and he chose to keep it going. So we'll be back to see her at the end of April for a follow-up. Here's hoping that his blood pressure is back down and his eGFR is back up!