A couple of years ago, this would have been a post about drinking too much booze in the airport lounge, on the plane and then with dinner on the first day of a new travel adventure but now things are a bit different. The danger now is drinking too much of anything, including water – a habit we are usually encouraged to take up in hot climates.
The problem is that with an eGFR function of just 15, the flow of blood through C’s kidneys is only 15ml per minute. Compare that to my healthy rate of 100ml per minute and you can start to see the issue.
For people without CKD, the kidneys can process excess fluid quickly out to the bladder as urine but with a significantly reduced kidney function, that fluid has nowhere to go.
But what about sweating? I hear you ask – excess water can leave that way, surely? Well yes, that’s usually an option in the heat and getting red faced and sweaty whilst trekking round Roman ruins was certainly my body’s way of dealing with the heat. But with CKD, the complications of reduced kidney function also interferes with other signals so patients can have an unquenchable thirst as well as a reduction in sweating.
The result? A confusion of signals and actions from the body leading to swollen ankles, puffy fingers and painful joints as a fluid traffic jam builds up in the body. The solution is to carefully monitor and control fluids into the body and not always believe signals like thirst. But it’s easier said than done and we are still working out causes and solutions to C’s retinue of symptoms.
Like many things it becomes a careful balance of enjoying a beer on a boat trip or an Aperol Spritz by the pool and just sipping water throughout the day rather than guzzling cocktails and 2litre bottles of water in rotation like we used to. Yes things have to change but being rigid and too restrictive takes the joy out of anything and what would be the point then in a holiday?
We don’t know when we will get a trip like this again so for now we are enjoying it and taking the time to plan all the adventures we will have post transplant. And there will be plenty of them – with lots of cocktails.