The body is a complex organism. There are many chemical reactions going on inside of us all of the time and we never give it a second thought most of the time. As processes happen others are triggered which compensate and result in a consistent environment which keeps us healthy most of the time. Biologists call this homeostasis.
I had never truly appreciated until recently the dynamic role that the kidney played in all of this. They play a big part in removing unwanted waste products (into the urine) and returning necessary salts back into the blood (potassium, sodium, calcium, chlorides and phosphates) as needed in order to provide a balance.
My kidney (singular) has been poorly for several months struggling on to do its job whilst being damaged by the Myleoma. This has caused me real problems in maintaining the concentrations of some of the above mentioned salts.
In the early days after diagnosis the potassium levels were far to high and at one point in April were such that they feared a heart attack, resulting in me being put on an EGG monitor and requiring a nebuliser. In hospital this was stabilised and by a combination of diet and drugs has remained stable for much of the time since. Each day I take sodium bicarbonate tablets to push the balance in such a way as to reduce the potassium ions (the sodium and potassium ions being in equilibrium). I avoid potatoes, bananas and other high potassium foods where possible.
More recently, here in Nottingham, the potassium levels have shot up again. This time they gave me a standard precursor to the stem cell treatment which required a does of potassium ions. Unfortunately this over compensated and so needed a couple of days of treatment to reduce it again.
At the same time there was a sudden elevation in my phosphate levels and consequent dropping of calcium. Again medication was needed – doubling the dose of Selvamer Carbonate (a phosphate binder) taken with food and for a couple of days taking calcium tablets. All of this intervention made possible with close monitoring of my blood samples taken twice daily.
The other area of homeostasis which went awry was in the water balance. This has been an issue from the word go. Swollen ankles and feet are part an parcel of the past few months and whilst here in Nottingham as preparation for the chemotherapy I needed to take on a lot of fluid (for protection). However, this put nearly 5 kg of weight on me and yet again needed intervention to bring into balance. I needed diuretic medication. The result was many many trips to the loo over several days. The result was in a couple of days I began to be dehydrated, requiring me to up my water intake.
Finally today I am back to my starting weight. I can also go back onto the normal food menu which is a good deal nicer than the renal one I have been on (an much more varied).
In the coming days they will continue to monitor me and ensure things stay in balance, I am sure that they will need to intervene at some point during the more challenging phase of the treatment, but I am confident that they will succeed in Getting the Balance Right.