It’s the beginning of 2021, and what better way to start the new year than to ensure your health is in order. Before you go ahead and plan out your year, it’s important to have your doctor examine your overall health first. 

As you check in with your healthcare provider, here are seven important physical and mental health checks you need to undergo:

1. Review your medications.

CKD Checklist: Senior holding pills

It’s crucial to regularly go over your medicines when you’re on a specific medication regimen. This is the time where you and your doctor review all the prescriptions and supplements you’re taking, assess how your body is responding to them based on your lab results, and evaluate how you’re feeling when taking them.

Depending on the findings, there will be changes and adjustments your doctor will recommend during your visits. According to Harvard Medical School, medicine checks are necessary if:

  • You’re taking five or more prescription medications, over-the-counter (OTC) drugs, or dietary supplements
  • You’re experiencing side effects 
  • You’re taking OTC drugs that may be interacting with your other medications
  • You just got out of the hospital (a medicine check is usually done within 2 weeks after being discharged)
  • You’re seeing a number of specialists
  • You need to discontinue taking a certain prescription
  • You’ve been taking medication for some time and your symptoms are not controlled. In this case, your doctor may give you a stronger dose or switch to a different drug

Medication check-ups should be part of your health maintenance. As much as possible, review your medications at least once a year. Don’t forget to bring all your medications (including supplements) to your doctor. 

Feel free to ask questions on any matters related to it, like why you need to take this or that drug, the side effects, and if there are inexpensive or generic medication options. And before leaving, ask for a complete list of all your medications, especially if there are any changes made.

2. Monitor your blood sugar level.

Regular blood sugar checks are essential for people with diabetes. Tracking and recording changes in your blood sugar levels helps you have a deeper understanding of how certain factors like your daily food choices, physical activities, and stress are affecting your condition. 

If you have type 1 diabetes, your doctor may ask you to test your blood sugar four or more times a day. This includes before and after meals and exercise (and more often when you’re sick). If you have type 2 diabetes, your doctor will let you know how often you should test your blood sugar levels. 

The American Diabetes Association’s (ADA) recommends the following blood sugar level for diabetics who are not pregnant:

  • Before meals - 80 to 130 mg/dL
  • One to two hours after meals - Below 180 mg/dL

Note that your range may be different if you have CKD or if your blood sugar is often low or high. You’ll need to determine your specific target blood sugar levels with your doctor based on your age, health status, treatment plan, and diagnosis. 

Make sure to follow your doctor’ recommendations and to stay within your target blood sugar range. This is crucial in preventing or slowing down complications associated with diabetes.

It’s also best to see an endocrinologist, a doctor who focuses on the treatment and management of diabetes and hormonal imbalances. An endocrinologist will check your weight, blood sugar level, blood pressure, cholesterol levels, blood fat, and glycated hemoglobin.

Not sure what to ask your doctor during your appointment? Here are some questions to keep in mind:

  • What’s my target blood sugar range?
  • How often should I test my blood sugar?
  • What do these numbers mean?
  • What patterns should I observe that may mean I need to change my treatment plan?
  • What changes should I make to improve my results?

If your results are above normal, your endocrinologist may recommend additional tests and adjust your treatment plan accordingly.

3. Keep up to date on flu and pneumonia vaccines.

CKD Checklist: Doctor giving vaccine senior woman

People with CKD and diabetes are highly encouraged to get vaccines for seasonal flu and pneumococcal diseases (i.e. pneumonia, meningitis, sinus infections, and bloodstream infections). 

Kidney disease can affect your body’s ability to fight off infections, which may result in serious complications that may lead to hospitalization and even death. Vaccination is the best way to protect yourself from infections.

The Center for Disease Control and Prevention (CDC) says that pneumococcal vaccines are safe and are recommended for all adults aged 65 years and older. The beginning of the year is an ideal time to get yourself vaccinated. 

What about for coronavirus disease (Covid-19)?

The CDC notes there are now authorized and available Covid-19 vaccines in the US. However, initial supplies are limited at the moment and are allocated for healthcare personnel and long-term care facility residents.

While the vaccines may be safe, the National Kidney Foundation (NKF) warns there is still no evidence of its effectiveness in people with kidney disease at any stage or those who are on dialysis. 

Doctors, however, agree that the benefits of the vaccine to the CKD population are greater than the possible risks or complications Covid-19 can cause. To learn more, talk to your doctor or other healthcare professionals about getting a Covid-19 vaccine.

4. Have your physical activity level checked.

Physical fitness is essential for everyone, including people with kidney disease. Regular exercise conditions the body, refuels your energy, and lifts your mood.

In addition, NKF emphasizes the following benefits of exercise for people with CKD:

  • Improved muscle strength
  • Better blood pressure control
  • Improved muscle physical conditioning
  • Reduced cholesterol
  • Reduced stress, anxiety, and depression
  • Better body weight control
  • Better sleep

Discuss with your doctor your plans of starting an exercise regimen. If you haven’t done any exercise in the past and your condition isn’t preventing you from performing physical activities, your doctor may recommend an exercise plan that suits you.

Factors like your current fitness level and exercise history will be considered in creating your exercise regimen. Elderly individuals and those who haven’t exercised in a long time are advised to start slowly with low-impact activities.

Some exercises your doctor may recommend include:

  • Walking
  • Cycling
  • Dancing
  • Yoga
  • Swimming
  • Home exercises (sitting, strength, flexibility, and balance exercises)

Too tired to exercise? Many CKD patients feel too weak or tired to move their bodies. This is often due to fatigue and muscle wasting, a common condition in predialysis and dialysis patients that decreases a person’s strength and ability to move.

Simply moving your body has a significant impact on your well-being. Small movements like standing up and walking around your house have the power to strengthen your muscles, improve your balance and stability, and improve your range of motion.

Regardless of your CKD stage, exercise is beneficial for your health. Regular physical activity can lower the risk of cardiovascular diseases. A study titled The Role of Physical Activity in the CKD Setting highlights that hypertension, inflammation, and oxidative stress may be improved with exercise in people with kidney disease. 

One year of supervised aerobic exercise training can even improve physical impairment in people with early-stage CKD. And many people can attest that the more you perform an exercise, the less tiring it becomes. This is because over time, your muscles get used to the activity.

If you want a more sweat-inducing activity, you can try the exercises above. Just make sure to talk to your doctor before getting into any physical activity.

5. Pay attention to your mental and emotional health.

Chronic kidney disease may not only take a toll on your physical health, it can affect your inner well-being as well. Before soldiering on to the new year, it helps to check in with your feelings and emotions first.

Depression is a prevalent mental health issue in people with CKD and end-stage renal disease (ESRD). It isn’t just a period of sadness; depression is an illness that requires professional and immediate treatment.

When left ignored, it can result in poorer health and lower quality of life. Depression and other mental health problems must be addressed with the same urgency as treating diabetes or detecting the initial signs of kidney disease.

The American Kidney Fund says that the first step to addressing depression in people with CKD is recognizing its symptoms. These include (but may not be limited to):

  • Difficulty sleeping
  • Anxiety
  • Unwanted feelings of dependence on healthcare providers
  • Feelings of helplessness over their situation
  • Lack of control over their schedule and lives
  • Feelings of hopelessness, thinking there’s no cure to their condition
  • Inability to stand up to societal pressures at the expense of their own health

Someone who has depression may also be irritable, always exhausted, have a declining appetite, have persistent feelings of sadness even in merry occasions, and have constant thoughts of death. 

If any or all of these signs and symptoms are evident, please seek immediate help. Talk to your doctor as they are more familiar with your overall condition. Your doctor could also help you sort out if the symptoms you’re experiencing are caused by depression or something else.

It could be that you’re feeling down due to tiredness, which is a possible effect of anemia. This can be remedied by taking medicines. Allow your doctor to evaluate your symptoms and be open about your feelings. By doing so, your doctor can give you a proper diagnosis or spot other possible aspects of CKD that need treatment.

How is depression treated?

If your doctor confirms that you have depression, they will put you on medications. Before seeing a psychiatrist for depression medications, consult with your doctor first so they can adjust your dosage according to what your kidneys can take. 

Along with medications, your doctor may also advise you to undergo psychotherapy or ‘talk therapy’ with a mental health professional. During each session, your therapist will ask you to describe your current situation, how you feel about it, your mood and behavior. Then your therapist will assist you in determining solutions to your problems including ways to cope with challenging situations in a healthy manner.

You may need two or more psychotherapy sessions that can last for months or years, depending on your situation, symptoms, and how quickly you make progress. Over time, talking about your concerns and gaining a different perspective can help improve your mood, change how you think and feel about yourself, and allow you to cope better with problems.

Depression is highly treatable. If you find yourself struggling with it, don’t hesitate to seek help and support. Don’t let depression get in the way of you experiencing a happy and satisfying life.

Let this be the year you actively take good care of your overall well-being. May you have a great 2021 ahead!


Sources:

7 Reasons Why You May Need a Medication Check-Up

https://www.health.harvard.edu/staying-healthy/7-reasons-why-you-may-need-a-medication-check-up 


Symptoms, Diagnosis and Monitoring of Diabetes

https://www.heart.org/en/health-topics/diabetes/symptoms-diagnosis--monitoring-of-diabetes


Blood Sugar Chart: What’s the Normal Range for Blood Sugar?

https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/blood-sugar-chart/


Vaccines, Kidney Disease, & COVID-19

https://www.kidney.org/coronavirus/vaccines-kidney-disease


Easy Exercises

https://www.nhs.uk/live-well/exercise/easy-low-impact-exercises/


The Role of Physical Activity in the CKD Setting

https://www.karger.com/Article/FullText/355783


Depression in Chronic Kidney Disease and End-Stage Renal Disease: Similarities and Differences in Diagnosis, Epidemiology, and Management

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5720531/


Psychotherapy

https://www.mayoclinic.org/tests-procedures/psychotherapy/about/pac-20384616