WEBVTT NOTE language:en-US NOTE Confidence: 0.8648055791854858 00:00:04.320 --> 00:00:09.555 Hello everyone, this is Doctor Bob, Doctor Bob Gebbe, Chief NOTE Confidence: 0.8648055791854858 00:00:09.644 --> 00:00:16.033 scientific Officer for the American Diabetes Association, and welcome to NOTE Confidence: 0.8648055791854858 00:00:16.122 --> 00:00:17.720 Dialogue with ADA. NOTE Confidence: 0.94695645570755 00:00:17.720 --> 00:00:22.001 And today's topic is a really important one, what you NOTE Confidence: 0.94695645570755 00:00:22.082 --> 00:00:25.880 need to know about diabetes and kidney disease. NOTE Confidence: 0.909602701663971 00:00:26.720 --> 00:00:32.423 And you know, this topic is so important because as NOTE Confidence: 0.909602701663971 00:00:32.535 --> 00:00:38.910 you'll learn more, the number one cause for severe kidney NOTE Confidence: 0.909602701663971 00:00:39.022 --> 00:00:43.719 disease and need for dialysis is diabetes. NOTE Confidence: 0.8778734803199768 00:00:43.760 --> 00:00:46.440 And sadly that's not changed. NOTE Confidence: 0.959149956703186 00:00:46.840 --> 00:00:49.966 But the good news is there's so much that can NOTE Confidence: 0.959149956703186 00:00:50.035 --> 00:00:53.787 be done to prevent kidney damage, and we'll talk about NOTE Confidence: 0.959149956703186 00:00:53.856 --> 00:00:54.760 that as well. NOTE Confidence: 0.9094470739364624 00:00:56.160 --> 00:01:00.534 It's it's really because of this that the American Diabetes NOTE Confidence: 0.9094470739364624 00:01:00.608 --> 00:01:05.501 Association has really been driving a kidney health initiative and NOTE Confidence: 0.9094470739364624 00:01:05.576 --> 00:01:09.876 working with partners that you'll meet today, one of which NOTE Confidence: 0.9094470739364624 00:01:09.950 --> 00:01:13.880 is DaVita, a really wonderful partner in this effort. NOTE Confidence: 0.8944194912910461 00:01:14.760 --> 00:01:17.260 And so we're going to have two speakers and I'm NOTE Confidence: 0.8944194912910461 00:01:17.313 --> 00:01:20.080 going to have them introduce themselves in a moment. NOTE Confidence: 0.9118722677230835 00:01:20.360 --> 00:01:23.465 But one of the things that's going to be fun NOTE Confidence: 0.9118722677230835 00:01:23.535 --> 00:01:26.994 is that we're going to get the perspective of the NOTE Confidence: 0.9118722677230835 00:01:27.064 --> 00:01:31.370 healthcare professional, but we're also going to get the real NOTE Confidence: 0.9118722677230835 00:01:31.440 --> 00:01:35.393 life story of someone living with diabetes and get their NOTE Confidence: 0.9118722677230835 00:01:35.463 --> 00:01:36.239 impression. NOTE Confidence: 0.9194645285606384 00:01:36.240 --> 00:01:39.548 And we hope through through all of that you get NOTE Confidence: 0.9194645285606384 00:01:39.619 --> 00:01:43.984 come out with a better understanding of the connection between NOTE Confidence: 0.9194645285606384 00:01:44.054 --> 00:01:48.419 diabetes and kidney disease and most importantly, what you can NOTE Confidence: 0.9194645285606384 00:01:48.489 --> 00:01:51.798 do and spreading the word to your loved ones to NOTE Confidence: 0.9194645285606384 00:01:51.868 --> 00:01:53.840 maintain good kidney health. NOTE Confidence: 0.952853798866272 00:01:54.240 --> 00:01:56.120 So I'm going to start. NOTE Confidence: 0.9373977184295654 00:01:56.360 --> 00:01:59.560 Tina, can you introduce yourself to the audience? NOTE Confidence: 0.8781158328056335 00:02:00.360 --> 00:02:01.080 Sure. NOTE Confidence: 0.973278284072876 00:02:01.080 --> 00:02:02.000 Thank you. NOTE Confidence: 0.8490306735038757 00:02:03.280 --> 00:02:07.081 As as you mentioned, my name is Tina Levidae and NOTE Confidence: 0.8490306735038757 00:02:07.161 --> 00:02:11.279 I am currently the Chief Nursing Officer for DaVita. NOTE Confidence: 0.9088129997253418 00:02:11.760 --> 00:02:16.580 I am a registered nurse and have spent really my NOTE Confidence: 0.9088129997253418 00:02:16.681 --> 00:02:20.999 lifetime and career working in kidney care. NOTE Confidence: 0.924916684627533 00:02:21.000 --> 00:02:24.708 I've been with DaVita for more than 27 years and NOTE Confidence: 0.924916684627533 00:02:24.785 --> 00:02:29.035 really have dedicated my life's work to ensure that I'm NOTE Confidence: 0.924916684627533 00:02:29.112 --> 00:02:33.439 able to contribute just really meaningful in the care of NOTE Confidence: 0.924916684627533 00:02:33.516 --> 00:02:38.461 patients with kidney disease and also participate in events like NOTE Confidence: 0.924916684627533 00:02:38.538 --> 00:02:43.406 this where we're able to educate other patients around delaying NOTE Confidence: 0.924916684627533 00:02:43.483 --> 00:02:44.720 the progression. NOTE Confidence: 0.8780511617660522 00:02:44.720 --> 00:02:47.745 So super excited to be here and and thanks for NOTE Confidence: 0.8780511617660522 00:02:47.810 --> 00:02:48.600 inviting me. NOTE Confidence: 0.9518315196037292 00:02:49.520 --> 00:02:51.360 Great and great to have you Tina. NOTE Confidence: 0.8037132024765015 00:02:51.360 --> 00:02:56.193 And then Tiffany, you are an amazing woman is when NOTE Confidence: 0.8037132024765015 00:02:56.289 --> 00:02:58.319 you come to know you. NOTE Confidence: 0.9483936429023743 00:02:58.360 --> 00:03:01.448 So please introduce yourself and tell a little bit about NOTE Confidence: 0.9483936429023743 00:03:01.503 --> 00:03:02.000 yourself. NOTE Confidence: 0.904578685760498 00:03:02.440 --> 00:03:04.720 Well, thank you for that intro. NOTE Confidence: 0.7618713974952698 00:03:05.920 --> 00:03:08.040 No, my name is Tiffany Martin. NOTE Confidence: 0.8885110020637512 00:03:08.480 --> 00:03:12.992 I've had type 1 juvenile diabetes almost going on 30 NOTE Confidence: 0.8885110020637512 00:03:13.079 --> 00:03:13.599 years. NOTE Confidence: 0.6945906281471252 00:03:13.600 --> 00:03:15.160 I'm I'm almost telling my age. NOTE Confidence: 0.8772763013839722 00:03:16.600 --> 00:03:19.440 I am a recent kidney recipient. NOTE Confidence: 0.9475870132446289 00:03:19.680 --> 00:03:24.202 This would actually have been my second one and when NOTE Confidence: 0.9475870132446289 00:03:24.289 --> 00:03:27.334 I was 27 I lost my sight as well as NOTE Confidence: 0.9475870132446289 00:03:27.421 --> 00:03:31.857 my kidney function and that started me on my kidney NOTE Confidence: 0.9475870132446289 00:03:31.944 --> 00:03:32.639 journey. NOTE Confidence: 0.9290317296981812 00:03:33.120 --> 00:03:37.539 And so now I am all about advocacy and sharing NOTE Confidence: 0.9290317296981812 00:03:37.635 --> 00:03:42.151 light on my story to prevent anybody as much as NOTE Confidence: 0.9290317296981812 00:03:42.247 --> 00:03:46.667 I can with sharing from enduring what I and my NOTE Confidence: 0.9290317296981812 00:03:46.763 --> 00:03:51.759 loved ones had to go through with my health journey. NOTE Confidence: 0.8907826542854309 00:03:52.800 --> 00:03:55.360 Yeah, thank you Tiffany for sharing that. NOTE Confidence: 0.8437195420265198 00:03:55.360 --> 00:03:59.526 And your, your story, as we'll continue to hear on NOTE Confidence: 0.8437195420265198 00:03:59.610 --> 00:04:03.860 this is, is inspiring and, and, and your courage is NOTE Confidence: 0.8437195420265198 00:04:03.943 --> 00:04:05.360 really wonderful. NOTE Confidence: 0.8838635087013245 00:04:05.840 --> 00:04:08.518 So let, let's jump right into it And I'll, I'll, NOTE Confidence: 0.8838635087013245 00:04:08.574 --> 00:04:11.532 you know, for the audience, put your questions in the NOTE Confidence: 0.8838635087013245 00:04:11.588 --> 00:04:14.825 chat because we've got some questions already that we want NOTE Confidence: 0.8838635087013245 00:04:14.881 --> 00:04:17.559 to cover, but we'd love to answer yours as well. NOTE Confidence: 0.8545514941215515 00:04:17.920 --> 00:04:20.600 So Tina, let let's start with the basics. NOTE Confidence: 0.9522580504417419 00:04:20.600 --> 00:04:22.880 So what is chronic kidney disease? NOTE Confidence: 0.8417270183563232 00:04:23.640 --> 00:04:26.387 Sure, this is a a great question and I think NOTE Confidence: 0.8417270183563232 00:04:26.449 --> 00:04:29.634 I will definitely start with the basics and not not NOTE Confidence: 0.8417270183563232 00:04:29.696 --> 00:04:31.320 make any assumptions here. NOTE Confidence: 0.9021887183189392 00:04:31.320 --> 00:04:34.894 So let me just start by saying and sharing what NOTE Confidence: 0.9021887183189392 00:04:34.970 --> 00:04:36.720 what do the kidneys do? NOTE Confidence: 0.9377785325050354 00:04:37.839 --> 00:04:42.453 So the kidneys when functioning properly, help our body filter NOTE Confidence: 0.9377785325050354 00:04:42.528 --> 00:04:46.546 waste and excess fluid from our blood and it's removed NOTE Confidence: 0.9377785325050354 00:04:46.620 --> 00:04:50.341 from our blood and it passes from the body through NOTE Confidence: 0.9377785325050354 00:04:50.415 --> 00:04:51.159 urination. NOTE Confidence: 0.9356281757354736 00:04:51.640 --> 00:04:55.637 And So what what CKD is or otherwise known as NOTE Confidence: 0.9356281757354736 00:04:55.726 --> 00:05:00.879 chronic kidney disease, is a gradual loss of that function NOTE Confidence: 0.9356281757354736 00:05:00.968 --> 00:05:05.943 or gradual damage to the kidneys, which could in reality NOTE Confidence: 0.9356281757354736 00:05:06.032 --> 00:05:08.519 take many years to progress. NOTE Confidence: 0.9491593241691589 00:05:08.880 --> 00:05:13.200 But what happens is the kidney function slowly declines. NOTE Confidence: 0.9508810639381409 00:05:13.200 --> 00:05:17.155 And so that inability of a healthy kidney to process NOTE Confidence: 0.9508810639381409 00:05:17.231 --> 00:05:21.719 the fluid and the waste from your bloodstream really fails. NOTE Confidence: 0.9130766987800598 00:05:22.120 --> 00:05:25.735 And so that can result in a buildup of excess NOTE Confidence: 0.9130766987800598 00:05:25.816 --> 00:05:31.280 waste fluid, electrolytes that really can make you unhealthy, right? NOTE Confidence: 0.9569839835166931 00:05:31.279 --> 00:05:36.127 And if it continues to fail, can lead to a NOTE Confidence: 0.9569839835166931 00:05:36.242 --> 00:05:38.319 need for dialysis. NOTE Confidence: 0.906535267829895 00:05:39.000 --> 00:05:43.156 And as you mentioned earlier, Doctor Gabe, I think this NOTE Confidence: 0.906535267829895 00:05:43.232 --> 00:05:47.767 this discussion really is just so relevant for this audience NOTE Confidence: 0.906535267829895 00:05:47.842 --> 00:05:52.150 because as we know, diabetes is the leading indicator for NOTE Confidence: 0.906535267829895 00:05:52.226 --> 00:05:53.359 kidney failure. NOTE Confidence: 0.9578971862792969 00:05:53.600 --> 00:05:56.662 And so I think it's important for this audience in NOTE Confidence: 0.9578971862792969 00:05:56.724 --> 00:06:00.032 particular to understand that they are at risk for CKD NOTE Confidence: 0.9578971862792969 00:06:00.093 --> 00:06:02.360 or chronic kidney disease in general. NOTE Confidence: 0.9739630222320557 00:06:02.720 --> 00:06:05.690 And there is a lot of actions that you can NOTE Confidence: 0.9739630222320557 00:06:05.761 --> 00:06:07.600 take to help prevent that. NOTE Confidence: 0.8713237643241882 00:06:08.760 --> 00:06:11.808 And it's just also why I'm excited about the Vita's NOTE Confidence: 0.8713237643241882 00:06:11.868 --> 00:06:15.754 relationship with ADA, to help create this awareness for patients NOTE Confidence: 0.8713237643241882 00:06:15.814 --> 00:06:19.461 who are living with diabetes and ultimately help them prevent NOTE Confidence: 0.8713237643241882 00:06:19.520 --> 00:06:19.759 CKD. NOTE Confidence: 0.5636829733848572 00:06:20.880 --> 00:06:21.920 Thanks, Tina. NOTE Confidence: 0.9133684635162354 00:06:22.000 --> 00:06:22.920 Yeah, really. NOTE Confidence: 0.9449941515922546 00:06:22.920 --> 00:06:25.548 You know, we want people to know more so that NOTE Confidence: 0.9449941515922546 00:06:25.606 --> 00:06:28.351 they can do the things to ensure that they have NOTE Confidence: 0.9449941515922546 00:06:28.410 --> 00:06:29.520 good kidney health. NOTE Confidence: 0.868941068649292 00:06:29.520 --> 00:06:33.252 And thanks for describing what the kidneys do and, and NOTE Confidence: 0.868941068649292 00:06:33.321 --> 00:06:36.501 CKD, We'll, we'll use CKD for the rest of this NOTE Confidence: 0.868941068649292 00:06:36.570 --> 00:06:38.159 chronic kidney disease. NOTE Confidence: 0.9147171974182129 00:06:38.160 --> 00:06:39.320 Just easier to say. NOTE Confidence: 0.9330769777297974 00:06:39.760 --> 00:06:44.361 So Tiffany, tell us a little bit about, you know, NOTE Confidence: 0.9330769777297974 00:06:44.455 --> 00:06:46.240 your CKD diagnosis. NOTE Confidence: 0.9758709669113159 00:06:46.240 --> 00:06:47.560 Like what was it like? NOTE Confidence: 0.9692807197570801 00:06:47.680 --> 00:06:50.120 When did you find out that you had CKD? NOTE Confidence: 0.9198232889175415 00:06:51.680 --> 00:06:56.282 So what I noticed, I was at work and I NOTE Confidence: 0.9198232889175415 00:06:56.403 --> 00:07:00.400 had noticed I was very lethargic. NOTE Confidence: 0.9147594571113586 00:07:01.320 --> 00:07:06.339 And then I started kind of gaining this weight that NOTE Confidence: 0.9147594571113586 00:07:06.437 --> 00:07:12.145 I couldn't really account for and realized I was retaining NOTE Confidence: 0.9147594571113586 00:07:12.243 --> 00:07:13.719 a lot of fluid. NOTE Confidence: 0.9664487838745117 00:07:13.720 --> 00:07:15.320 So it was a lot of puffiness. NOTE Confidence: 0.9193243384361267 00:07:15.880 --> 00:07:20.723 There was, I noticed, a lack of urination and it NOTE Confidence: 0.9193243384361267 00:07:20.824 --> 00:07:24.658 got to a point to where the best way I NOTE Confidence: 0.9193243384361267 00:07:24.759 --> 00:07:30.309 can describe it was just kind of drowning without being NOTE Confidence: 0.9193243384361267 00:07:30.410 --> 00:07:31.520 underwater. NOTE Confidence: 0.912496030330658 00:07:31.800 --> 00:07:34.466 It was a lot of coughing, a lot of fluid NOTE Confidence: 0.912496030330658 00:07:34.533 --> 00:07:35.399 in the lungs. NOTE Confidence: 0.9095516204833984 00:07:35.880 --> 00:07:39.358 So when we went to the doctors, what they did NOTE Confidence: 0.9095516204833984 00:07:39.435 --> 00:07:44.073 is released all the fluid, the various, you know, techniques NOTE Confidence: 0.9095516204833984 00:07:44.151 --> 00:07:47.784 and methods, you know, to try to get that under NOTE Confidence: 0.9095516204833984 00:07:47.861 --> 00:07:48.480 control. NOTE Confidence: 0.8720084428787231 00:07:49.040 --> 00:07:52.953 And kind of before we knew it, I was on, NOTE Confidence: 0.8720084428787231 00:07:53.051 --> 00:07:56.280 you know, PT peritoneal dialysis. NOTE Confidence: 0.8899272680282593 00:07:57.080 --> 00:08:01.292 They had implanted the tube and after that it was NOTE Confidence: 0.8899272680282593 00:08:01.378 --> 00:08:06.537 immediately going to DaVita, which I would say going through NOTE Confidence: 0.8899272680282593 00:08:06.623 --> 00:08:10.922 all of you know, that life change and that turmoil NOTE Confidence: 0.8899272680282593 00:08:11.008 --> 00:08:13.759 and such a a small span of time. NOTE Confidence: 0.9433455467224121 00:08:14.440 --> 00:08:16.600 The nurse and I'll never forget her. NOTE Confidence: 0.7571532130241394 00:08:16.600 --> 00:08:18.000 Her name was Retina. NOTE Confidence: 0.9214973449707031 00:08:18.600 --> 00:08:25.000 She was an incredible resource and support throughout the entire NOTE Confidence: 0.9214973449707031 00:08:25.100 --> 00:08:30.200 ordeal, educating US on, you know, what to do next, NOTE Confidence: 0.9214973449707031 00:08:30.300 --> 00:08:36.400 educating my parents, providing support, you know, to both of NOTE Confidence: 0.9214973449707031 00:08:36.500 --> 00:08:41.400 them on how to function, you know, within in that NOTE Confidence: 0.9214973449707031 00:08:41.500 --> 00:08:44.000 space through everything. NOTE Confidence: 0.918721079826355 00:08:44.000 --> 00:08:47.963 So it was, it was a whirlwind and it was NOTE Confidence: 0.918721079826355 00:08:48.062 --> 00:08:53.612 really for me an emotional time experiencing it with the NOTE Confidence: 0.918721079826355 00:08:53.711 --> 00:08:58.269 people that I love because it was also a life, NOTE Confidence: 0.918721079826355 00:08:58.368 --> 00:09:03.125 a life change, a life altering event for them as NOTE Confidence: 0.918721079826355 00:09:03.224 --> 00:09:03.720 well. NOTE Confidence: 0.8758086562156677 00:09:04.800 --> 00:09:09.113 You know, going from, you know, this normal lifestyle into, NOTE Confidence: 0.8758086562156677 00:09:09.186 --> 00:09:13.573 you know, they're becoming nurses overnight and just kind of NOTE Confidence: 0.8758086562156677 00:09:13.647 --> 00:09:17.156 that weight of what was happening to me and, and NOTE Confidence: 0.8758086562156677 00:09:17.229 --> 00:09:20.519 feeling it experienced through everyone else. NOTE Confidence: 0.9633885622024536 00:09:20.880 --> 00:09:21.440 It was. NOTE Confidence: 0.9000834822654724 00:09:21.440 --> 00:09:25.234 It took a toll mentally just as much as it NOTE Confidence: 0.9000834822654724 00:09:25.324 --> 00:09:26.680 did physically. NOTE Confidence: 0.7446248531341553 00:09:27.080 --> 00:09:30.560 So then thanks for sharing that. NOTE Confidence: 0.8538908958435059 00:09:30.559 --> 00:09:34.460 And it, it, it sounds like it, it was a NOTE Confidence: 0.8538908958435059 00:09:34.560 --> 00:09:39.060 lot to absorb and, and, and it sounds like it NOTE Confidence: 0.8538908958435059 00:09:39.160 --> 00:09:43.760 you didn't even realize you had kidney issues. NOTE Confidence: 0.7054243087768555 00:09:44.760 --> 00:09:46.080 No, to be Yeah. NOTE Confidence: 0.9084460139274597 00:09:46.480 --> 00:09:50.211 No, to be honest, I was visiting my sister in NOTE Confidence: 0.9084460139274597 00:09:50.294 --> 00:09:54.025 Colorado, and I kind of took it to like, the, NOTE Confidence: 0.9084460139274597 00:09:54.108 --> 00:09:58.585 you know, altitude of, you know, the, the air thinning NOTE Confidence: 0.9084460139274597 00:09:58.668 --> 00:09:59.000 out. NOTE Confidence: 0.8909770250320435 00:09:59.000 --> 00:10:02.042 And I'm like, well, maybe, you know, maybe it's dead NOTE Confidence: 0.8909770250320435 00:10:02.100 --> 00:10:04.733 and maybe it's jet lag and, you know, maybe I NOTE Confidence: 0.8909770250320435 00:10:04.792 --> 00:10:07.425 just need to go walk or, you know, drink more NOTE Confidence: 0.8909770250320435 00:10:07.483 --> 00:10:10.759 water, which was, you know, counteractive to everything. NOTE Confidence: 0.9030320644378662 00:10:11.120 --> 00:10:16.036 And it wasn't until I flew from Denver to New NOTE Confidence: 0.9030320644378662 00:10:16.145 --> 00:10:20.079 York to go on a date with who now is NOTE Confidence: 0.9030320644378662 00:10:20.188 --> 00:10:22.920 my husband that I really. NOTE Confidence: 0.30806028842926025 00:10:23.880 --> 00:10:24.040 Yeah. NOTE Confidence: 0.9104161858558655 00:10:24.640 --> 00:10:27.487 I realized as soon as he picked me up from NOTE Confidence: 0.9104161858558655 00:10:27.555 --> 00:10:30.200 the airport, I immediately fell asleep. NOTE Confidence: 0.9516551494598389 00:10:30.760 --> 00:10:32.600 And he was, you know, are you OK? NOTE Confidence: 0.8874800205230713 00:10:32.600 --> 00:10:34.040 And I'm like, I don't really. NOTE Confidence: 0.933117687702179 00:10:34.040 --> 00:10:37.821 I didn't really know what was happening at the time, NOTE Confidence: 0.933117687702179 00:10:37.894 --> 00:10:41.094 but my body was starting to shut down and it NOTE Confidence: 0.933117687702179 00:10:41.167 --> 00:10:44.658 was just very noticeable as I was just trying to NOTE Confidence: 0.933117687702179 00:10:44.730 --> 00:10:49.240 maneuver and navigate, you know, life as you would day-to-day. NOTE Confidence: 0.8600559234619141 00:10:49.640 --> 00:10:54.342 And it was very, it was very obvious that something NOTE Confidence: 0.8600559234619141 00:10:54.434 --> 00:10:58.399 was was wrong during those traveling times. NOTE Confidence: 0.8371251225471497 00:10:59.200 --> 00:10:59.520 Yeah. NOTE Confidence: 0.8985495567321777 00:11:00.240 --> 00:11:03.368 And, and, and so Tina, like how, you know, we NOTE Confidence: 0.8985495567321777 00:11:03.438 --> 00:11:07.053 heard about some of the symptoms that, you know, can NOTE Confidence: 0.8985495567321777 00:11:07.123 --> 00:11:10.530 develop and, and then how common is it for people NOTE Confidence: 0.8985495567321777 00:11:10.599 --> 00:11:13.519 not to know that they have kidney disease? NOTE Confidence: 0.8986157774925232 00:11:14.240 --> 00:11:16.800 Yeah, it's, it's actually pretty common. NOTE Confidence: 0.8543444275856018 00:11:16.800 --> 00:11:19.480 So Tiffany's story is not unusual. NOTE Confidence: 0.8193872570991516 00:11:20.679 --> 00:11:25.468 The Yeah, the the signs and symptoms for CKD are NOTE Confidence: 0.8193872570991516 00:11:25.568 --> 00:11:29.360 just really gradual and really subtle. NOTE Confidence: 0.8373983502388 00:11:29.440 --> 00:11:32.280 And so they're they're very easy to miss. NOTE Confidence: 0.9635857343673706 00:11:32.320 --> 00:11:34.560 And I'll just share just a couple of them. NOTE Confidence: 0.9110819101333618 00:11:34.559 --> 00:11:37.203 And Tiffany, you did a great job of explaining a NOTE Confidence: 0.9110819101333618 00:11:37.258 --> 00:11:38.799 couple that you experienced. NOTE Confidence: 0.8829976916313171 00:11:38.840 --> 00:11:42.405 I mean, definitely a lack of energy, being lethargic is NOTE Confidence: 0.8829976916313171 00:11:42.470 --> 00:11:42.599 1. NOTE Confidence: 0.9167470335960388 00:11:42.840 --> 00:11:47.149 Sometimes patients might experience kind of a metallic taste in NOTE Confidence: 0.9167470335960388 00:11:47.217 --> 00:11:50.500 their mouth or what some people refer to as kind NOTE Confidence: 0.9167470335960388 00:11:50.568 --> 00:11:51.800 of ammonia breath. NOTE Confidence: 0.8846493363380432 00:11:52.960 --> 00:11:58.985 Sometimes there's nausea and vomiting, a general lack of appetite, NOTE Confidence: 0.8846493363380432 00:11:59.076 --> 00:12:00.720 Tiffany mentioned. NOTE Confidence: 0.8843387365341187 00:12:00.720 --> 00:12:04.619 About kind of the shortness of breath and the the NOTE Confidence: 0.8843387365341187 00:12:04.698 --> 00:12:08.279 swelling that can potentially accompany that. NOTE Confidence: 0.9128577709197998 00:12:09.440 --> 00:12:13.130 I, I often refer to this as the, as the NOTE Confidence: 0.9128577709197998 00:12:13.224 --> 00:12:14.360 pillow test. NOTE Confidence: 0.9715403914451599 00:12:14.600 --> 00:12:18.268 So sometimes you can see a change in the number NOTE Confidence: 0.9715403914451599 00:12:18.346 --> 00:12:21.000 of pillows that you need to sleep. NOTE Confidence: 0.894000232219696 00:12:21.280 --> 00:12:23.879 The more pillows, if you're having difficulty breathing, the more NOTE Confidence: 0.894000232219696 00:12:23.919 --> 00:12:25.039 pillows you're going to add. NOTE Confidence: 0.8940833210945129 00:12:25.040 --> 00:12:27.900 So you're, you're sitting up as you're sleeping through the NOTE Confidence: 0.8940833210945129 00:12:27.949 --> 00:12:28.239 night. NOTE Confidence: 0.9244830012321472 00:12:28.280 --> 00:12:31.680 That could be potentially a, a symptom. NOTE Confidence: 0.8611164689064026 00:12:32.080 --> 00:12:36.066 And then Tiffany referred to this as well, but a NOTE Confidence: 0.8611164689064026 00:12:36.149 --> 00:12:40.717 change in urination could also potentially be a, a sign NOTE Confidence: 0.8611164689064026 00:12:40.800 --> 00:12:41.879 or a symptom. NOTE Confidence: 0.9281339049339294 00:12:42.160 --> 00:12:46.862 So it could be, you know, either urinating more, urinating NOTE Confidence: 0.9281339049339294 00:12:46.943 --> 00:12:51.727 less frequently, foaming in your, your urine, blood in your NOTE Confidence: 0.9281339049339294 00:12:51.808 --> 00:12:54.159 urine could be a possibility. NOTE Confidence: 0.8853992819786072 00:12:54.800 --> 00:12:57.542 So all of those things are, are, are things that NOTE Confidence: 0.8853992819786072 00:12:57.599 --> 00:12:59.199 you would want to watch for. NOTE Confidence: 0.85948246717453 00:12:59.440 --> 00:13:02.479 But again, I will just iterate that it's gradual and NOTE Confidence: 0.85948246717453 00:13:02.538 --> 00:13:03.999 they're extremely subtle. NOTE Confidence: 0.859490156173706 00:13:04.000 --> 00:13:05.880 So they're very easy to miss. NOTE Confidence: 0.895956814289093 00:13:05.920 --> 00:13:09.908 And so thinking about a patient who has diabetes or NOTE Confidence: 0.895956814289093 00:13:09.986 --> 00:13:14.912 someone who has diabetes, the probably most important action to NOTE Confidence: 0.895956814289093 00:13:14.990 --> 00:13:19.213 take would be to get tested annually by your physician NOTE Confidence: 0.895956814289093 00:13:19.291 --> 00:13:23.436 because that is going to be your indicator to whether NOTE Confidence: 0.895956814289093 00:13:23.514 --> 00:13:28.206 or not you're progressing towards kidney disease in, in the, NOTE Confidence: 0.895956814289093 00:13:28.284 --> 00:13:31.959 in the missing of potential signs and symptoms. NOTE Confidence: 0.827284038066864 00:13:32.600 --> 00:13:35.240 Yeah, that's a really good, important point, Tina. NOTE Confidence: 0.8833463191986084 00:13:35.240 --> 00:13:38.448 So there are a bunch of signs and symptoms, but NOTE Confidence: 0.8833463191986084 00:13:38.517 --> 00:13:42.886 they really don't happen until pretty late, like pretty advanced NOTE Confidence: 0.8833463191986084 00:13:42.954 --> 00:13:46.709 like your, your kidneys are functioning at a really low NOTE Confidence: 0.8833463191986084 00:13:46.778 --> 00:13:50.464 level and, and then it's, you know, can be challenging NOTE Confidence: 0.8833463191986084 00:13:50.533 --> 00:13:52.240 to do much at that point. NOTE Confidence: 0.8717209696769714 00:13:54.000 --> 00:13:58.403 At the same time, a simple blood and urine test NOTE Confidence: 0.8717209696769714 00:13:58.497 --> 00:14:00.839 will tell you right away. NOTE Confidence: 0.8765971660614014 00:14:01.520 --> 00:14:03.972 So it's it's not hard to figure out whether someone NOTE Confidence: 0.8765971660614014 00:14:04.020 --> 00:14:06.039 has kidney disease is just getting tested. NOTE Confidence: 0.5595921277999878 00:14:06.760 --> 00:14:08.520 Exactly and. NOTE Confidence: 0.8704285621643066 00:14:08.520 --> 00:14:12.211 That's, and that's why the recommendations, you know, are to, NOTE Confidence: 0.8704285621643066 00:14:12.271 --> 00:14:14.994 you know, at least yearly to be tested and to NOTE Confidence: 0.8704285621643066 00:14:15.055 --> 00:14:17.960 talk to your healthcare professional about that. NOTE Confidence: 0.9221206307411194 00:14:18.440 --> 00:14:21.998 So we've heard a little bit of, you know, what NOTE Confidence: 0.9221206307411194 00:14:22.076 --> 00:14:25.634 the, what kidney disease is and CKD is and how NOTE Confidence: 0.9221206307411194 00:14:25.712 --> 00:14:29.734 we might not realize it till you're pretty far along NOTE Confidence: 0.9221206307411194 00:14:29.812 --> 00:14:32.519 and that you can diagnose it early. NOTE Confidence: 0.8674985766410828 00:14:32.520 --> 00:14:35.893 So what can you do to prevent kidney disease And, NOTE Confidence: 0.8674985766410828 00:14:35.962 --> 00:14:38.785 and maybe Tina you if you want to share a NOTE Confidence: 0.8674985766410828 00:14:38.854 --> 00:14:40.920 little bit of some some ideas. NOTE Confidence: 0.9773305654525757 00:14:41.600 --> 00:14:41.840 Yeah. NOTE Confidence: 0.8861314058303833 00:14:41.840 --> 00:14:45.067 I think, I think first and foremost we, we just NOTE Confidence: 0.8861314058303833 00:14:45.136 --> 00:14:49.531 mentioned this, but I think it's extremely important that you're NOTE Confidence: 0.8861314058303833 00:14:49.599 --> 00:14:52.758 under the care of a physician and that you are NOTE Confidence: 0.8861314058303833 00:14:52.827 --> 00:14:56.192 screened every single year via a urine or a urine NOTE Confidence: 0.8861314058303833 00:14:56.261 --> 00:14:57.359 or a blood test. NOTE Confidence: 0.9380584359169006 00:14:57.800 --> 00:15:02.000 So definitely stay under the advisement of your physician. NOTE Confidence: 0.9590412974357605 00:15:02.400 --> 00:15:05.982 I think one of the things that is probably the NOTE Confidence: 0.9590412974357605 00:15:06.060 --> 00:15:09.798 most simple thing to do is to ensure that you're NOTE Confidence: 0.9590412974357605 00:15:09.876 --> 00:15:15.017 taking your medications as prescribed, both your diabetes and your NOTE Confidence: 0.9590412974357605 00:15:15.095 --> 00:15:17.119 blood pressure medication. NOTE Confidence: 0.9265276193618774 00:15:18.120 --> 00:15:21.683 We talked earlier about diabetes being one of the leading NOTE Confidence: 0.9265276193618774 00:15:21.745 --> 00:15:25.746 indicators or causes for kidney failure, and that's because high NOTE Confidence: 0.9265276193618774 00:15:25.809 --> 00:15:29.310 blood sugar levels as well as high blood pressure really NOTE Confidence: 0.9265276193618774 00:15:29.372 --> 00:15:32.810 damage the vessels in the kidney, which could then lead NOTE Confidence: 0.9265276193618774 00:15:32.873 --> 00:15:36.874 to to continued damage and ultimately to the progression towards NOTE Confidence: 0.9265276193618774 00:15:36.936 --> 00:15:40.000 failure, which is what we're we're talking about. NOTE Confidence: 0.9275066256523132 00:15:40.000 --> 00:15:43.617 And so you should definitely ensure that you're taking your NOTE Confidence: 0.9275066256523132 00:15:43.679 --> 00:15:47.235 medications as prescribed by your doctor to make sure that NOTE Confidence: 0.9275066256523132 00:15:47.297 --> 00:15:50.485 you're keeping your blood sugar as well as your your NOTE Confidence: 0.9275066256523132 00:15:50.547 --> 00:15:53.920 blood pressure under control to limit that that damage. NOTE Confidence: 0.9564842581748962 00:15:55.040 --> 00:16:00.055 And then I also would recommend that you understand your NOTE Confidence: 0.9564842581748962 00:16:00.145 --> 00:16:03.280 risk level for, for kidney disease. NOTE Confidence: 0.8798186182975769 00:16:03.640 --> 00:16:08.760 And we are, you know, have been working with the NOTE Confidence: 0.8798186182975769 00:16:08.866 --> 00:16:13.986 ADA and you can go to thediabetes.org or well as NOTE Confidence: 0.8798186182975769 00:16:14.093 --> 00:16:16.120 well as davita.com. NOTE Confidence: 0.9157243371009827 00:16:16.160 --> 00:16:20.286 And we have developed just a 62nd kind of questionnaire NOTE Confidence: 0.9157243371009827 00:16:20.361 --> 00:16:24.112 that you can complete that will risk your give you NOTE Confidence: 0.9157243371009827 00:16:24.188 --> 00:16:27.939 an understanding of your risk as it relates to CKD NOTE Confidence: 0.9157243371009827 00:16:28.014 --> 00:16:29.440 and kidney failure. NOTE Confidence: 0.8772668242454529 00:16:29.840 --> 00:16:32.574 And so I would encourage you that you visit those NOTE Confidence: 0.8772668242454529 00:16:32.630 --> 00:16:34.640 websites and and take those quizzes. NOTE Confidence: 0.9087652564048767 00:16:35.000 --> 00:16:38.813 And then I think again, most importantly is to advocate NOTE Confidence: 0.9087652564048767 00:16:38.882 --> 00:16:43.736 for yourself with your physicians around getting screened annually for NOTE Confidence: 0.9087652564048767 00:16:43.805 --> 00:16:45.400 chronic kidney disease. NOTE Confidence: 0.9240943789482117 00:16:46.720 --> 00:16:49.080 You, you hit on all sorts of great things. NOTE Confidence: 0.7171646356582642 00:16:49.080 --> 00:16:52.593 I'm just gonna hammer them, you know, like get screened NOTE Confidence: 0.7171646356582642 00:16:52.657 --> 00:16:53.359 every year. NOTE Confidence: 0.9594278931617737 00:16:53.760 --> 00:16:55.680 Blood glucose, blood pressure. NOTE Confidence: 0.9758131504058838 00:16:55.680 --> 00:16:59.280 I mean, those three things can make all the difference. NOTE Confidence: 0.9100006818771362 00:17:00.360 --> 00:17:04.288 Tiffany, in your journey as as you reflect back, you NOTE Confidence: 0.9100006818771362 00:17:04.364 --> 00:17:08.142 know what, what do you, what might you have wanted NOTE Confidence: 0.9100006818771362 00:17:08.217 --> 00:17:11.920 to have known or done differently in all of this? NOTE Confidence: 0.888697624206543 00:17:13.400 --> 00:17:18.571 Differently, and it's kind of why I advocate so much NOTE Confidence: 0.888697624206543 00:17:18.671 --> 00:17:25.036 now, in particularly for the African American community, we look NOTE Confidence: 0.888697624206543 00:17:25.135 --> 00:17:29.909 at food more so as a comfort and not necessarily NOTE Confidence: 0.888697624206543 00:17:30.008 --> 00:17:31.600 energy and fuel. NOTE Confidence: 0.8745751976966858 00:17:32.520 --> 00:17:37.130 And with that in mind, we tend to lean toward NOTE Confidence: 0.8745751976966858 00:17:37.233 --> 00:17:42.766 foods that are more, you know, appeasing, you know, to NOTE Confidence: 0.8745751976966858 00:17:42.868 --> 00:17:48.299 our tummies as opposed to what they could possibly do NOTE Confidence: 0.8745751976966858 00:17:48.401 --> 00:17:53.319 to better our prolonged, you know, our lifespan. NOTE Confidence: 0.8955516815185547 00:17:53.960 --> 00:17:56.613 With that, you know, the, you know, your fried foods NOTE Confidence: 0.8955516815185547 00:17:56.664 --> 00:17:58.960 or things that are more heavy and comforting. NOTE Confidence: 0.9329832792282104 00:17:59.320 --> 00:18:03.782 And so I would have, if I could, you know, NOTE Confidence: 0.9329832792282104 00:18:03.888 --> 00:18:09.625 once I got older, altered, you know, my eating habits, NOTE Confidence: 0.9329832792282104 00:18:09.731 --> 00:18:15.149 just the, just the education now that I have about, NOTE Confidence: 0.9329832792282104 00:18:15.255 --> 00:18:20.673 you know, certain type of foods, you know, and then NOTE Confidence: 0.9329832792282104 00:18:20.780 --> 00:18:22.480 also moderation. NOTE Confidence: 0.929286539554596 00:18:22.920 --> 00:18:27.170 I know when people become or learn that they're diabetic, NOTE Confidence: 0.929286539554596 00:18:27.244 --> 00:18:30.600 they kind of, you know, I can't eat anything. NOTE Confidence: 0.8705074191093445 00:18:30.600 --> 00:18:32.440 And that's, that's not necessarily true. NOTE Confidence: 0.8144988417625427 00:18:32.960 --> 00:18:37.331 It's moderation and what you eat, you know, you can NOTE Confidence: 0.8144988417625427 00:18:37.417 --> 00:18:38.959 enjoy some things. NOTE Confidence: 0.8871898651123047 00:18:38.960 --> 00:18:42.311 You just have to work around those things, whether you NOTE Confidence: 0.8871898651123047 00:18:42.373 --> 00:18:46.160 know, adjusting your insulin, you know, increasing your work. NOTE Confidence: 0.778477668762207 00:18:46.160 --> 00:18:48.320 It's just, it's just management. NOTE Confidence: 0.8528825640678406 00:18:48.320 --> 00:18:52.854 More so also the intersectionality that I have between being NOTE Confidence: 0.8528825640678406 00:18:52.930 --> 00:18:56.331 an African American and a woman on the on the NOTE Confidence: 0.8528825640678406 00:18:56.407 --> 00:19:01.319 woman's side, it's, you know, we handle our stresses differently. NOTE Confidence: 0.9368589520454407 00:19:01.560 --> 00:19:05.351 And, you know, the stress on our body increases our, NOTE Confidence: 0.9368589520454407 00:19:05.424 --> 00:19:09.579 you know, blood pressure, which ultimately for me did not NOTE Confidence: 0.9368589520454407 00:19:09.652 --> 00:19:13.371 help, you know, the poor management that I had over NOTE Confidence: 0.9368589520454407 00:19:13.443 --> 00:19:17.672 my diabetes, but also contributed to me losing my eyesight NOTE Confidence: 0.9368589520454407 00:19:17.745 --> 00:19:21.390 from the high blood pressure as well as the kidney NOTE Confidence: 0.9368589520454407 00:19:21.463 --> 00:19:22.120 function. NOTE Confidence: 0.9491799473762512 00:19:22.320 --> 00:19:25.658 So it's just being mindful of those things that we NOTE Confidence: 0.9491799473762512 00:19:25.725 --> 00:19:29.931 really just don't, you know, don't take into consideration when NOTE Confidence: 0.9491799473762512 00:19:29.998 --> 00:19:31.200 we're just living. NOTE Confidence: 0.6705365777015686 00:19:31.200 --> 00:19:32.320 You know, it's stresses. NOTE Confidence: 0.7170581817626953 00:19:32.320 --> 00:19:34.280 Oh, it's work, It's normal. NOTE Confidence: 0.8909221291542053 00:19:34.960 --> 00:19:38.093 No, you might need to take some time, digress, figure NOTE Confidence: 0.8909221291542053 00:19:38.152 --> 00:19:41.462 out some solutions to bring that blood pressure down or, NOTE Confidence: 0.8909221291542053 00:19:41.521 --> 00:19:44.772 you know, when we're out socializing and eating or, you NOTE Confidence: 0.8909221291542053 00:19:44.832 --> 00:19:47.787 know, drinking, hey, might need to be a little bit NOTE Confidence: 0.8909221291542053 00:19:47.846 --> 00:19:51.571 more conscious about what you're putting into your body because NOTE Confidence: 0.8909221291542053 00:19:51.630 --> 00:19:53.640 like Tina mentioned, it's gradual. NOTE Confidence: 0.8601242303848267 00:19:54.280 --> 00:19:57.577 So you know, you're not going to have the immediate NOTE Confidence: 0.8601242303848267 00:19:57.642 --> 00:20:00.811 effects of oh, oh, you know, have this, you know, NOTE Confidence: 0.8601242303848267 00:20:00.875 --> 00:20:02.039 casual drink here. NOTE Confidence: 0.9103968143463135 00:20:02.640 --> 00:20:03.800 It won't affect me. NOTE Confidence: 0.8885689973831177 00:20:04.600 --> 00:20:07.446 You keep having these casual drinks over, you know, period NOTE Confidence: 0.8885689973831177 00:20:07.495 --> 00:20:09.802 of time, they start to stack up and then before NOTE Confidence: 0.8885689973831177 00:20:09.851 --> 00:20:10.439 you know it. NOTE Confidence: 0.8747228980064392 00:20:10.920 --> 00:20:14.072 You're too advanced in renal failure to be able to NOTE Confidence: 0.8747228980064392 00:20:14.136 --> 00:20:16.280 reverse any of those symptoms, so. NOTE Confidence: 0.8357096314430237 00:20:17.160 --> 00:20:18.680 Yeah, very, very true. NOTE Confidence: 0.8561127781867981 00:20:18.680 --> 00:20:21.952 And it's really again, catching things early, not letting them NOTE Confidence: 0.8561127781867981 00:20:22.004 --> 00:20:22.479 progress. NOTE Confidence: 0.8798097372055054 00:20:22.480 --> 00:20:25.907 And, and, and the other point that probably the audience NOTE Confidence: 0.8798097372055054 00:20:25.969 --> 00:20:29.580 should know is that you, you mentioned the African American NOTE Confidence: 0.8798097372055054 00:20:29.641 --> 00:20:33.498 community at higher risk for developing high blood pressure and NOTE Confidence: 0.8798097372055054 00:20:33.559 --> 00:20:37.170 much higher risk of developing kidney disease and high risk NOTE Confidence: 0.8798097372055054 00:20:37.232 --> 00:20:38.639 of developing diabetes. NOTE Confidence: 0.885701060295105 00:20:38.640 --> 00:20:42.470 So all of things, these things together really make it NOTE Confidence: 0.885701060295105 00:20:42.541 --> 00:20:46.372 that much more important to sort of pay attention, get NOTE Confidence: 0.885701060295105 00:20:46.443 --> 00:20:49.919 screened, get tested and and do the right things. NOTE Confidence: 0.8892855048179626 00:20:52.080 --> 00:20:53.400 If you don't mind, Tiffany. NOTE Confidence: 0.933932363986969 00:20:53.400 --> 00:20:58.902 So you tell us a little bit about your experience NOTE Confidence: 0.933932363986969 00:20:59.014 --> 00:21:02.719 with getting a kidney transplant. NOTE Confidence: 0.895275354385376 00:21:04.840 --> 00:21:07.440 So the the real question is which one? NOTE Confidence: 0.7439359426498413 00:21:08.600 --> 00:21:09.160 Yes, right. NOTE Confidence: 0.8583765029907227 00:21:09.160 --> 00:21:11.400 You, you actually have had more than one. NOTE Confidence: 0.8546725511550903 00:21:11.880 --> 00:21:14.856 So yes, if you want to just briefly, you know, NOTE Confidence: 0.8546725511550903 00:21:14.921 --> 00:21:18.415 tell people a little bit what what's involved and then NOTE Confidence: 0.8546725511550903 00:21:18.479 --> 00:21:21.262 and then I'm going to ask Tina a little bit NOTE Confidence: 0.8546725511550903 00:21:21.327 --> 00:21:23.915 to tell us like, you know, who can get a NOTE Confidence: 0.8546725511550903 00:21:23.979 --> 00:21:27.279 kidney transplant and you know, that kind of stuff. NOTE Confidence: 0.9331259727478027 00:21:28.440 --> 00:21:33.788 So leading up to it, there's a lot of testing, NOTE Confidence: 0.9331259727478027 00:21:33.904 --> 00:21:37.159 there's a lot of blood work. NOTE Confidence: 0.8669385313987732 00:21:37.920 --> 00:21:42.335 One thing that we or I focused on rather is NOTE Confidence: 0.8669385313987732 00:21:42.438 --> 00:21:47.880 my sister became vegan a couple years ago right after NOTE Confidence: 0.8669385313987732 00:21:47.983 --> 00:21:51.680 I got diagnosed with kidney disease. NOTE Confidence: 0.8777954578399658 00:21:52.200 --> 00:21:54.279 And so I kind of, you know, I'm, I like NOTE Confidence: 0.8777954578399658 00:21:54.333 --> 00:21:55.719 to say I'm vegan adjacent. NOTE Confidence: 0.8589463829994202 00:21:56.560 --> 00:21:59.690 So because a lot of her, you know, her, her NOTE Confidence: 0.8589463829994202 00:21:59.763 --> 00:22:03.185 cooking tips and you know how she went about it NOTE Confidence: 0.8589463829994202 00:22:03.258 --> 00:22:05.880 and applied it to what I was eating. NOTE Confidence: 0.8535574078559875 00:22:05.880 --> 00:22:09.531 So I kept my my weight, you know, and I, NOTE Confidence: 0.8535574078559875 00:22:09.623 --> 00:22:13.640 I kept in good shape, all things considered. NOTE Confidence: 0.9582408666610718 00:22:14.920 --> 00:22:18.520 I walked and everything because I didn't want any complications NOTE Confidence: 0.9582408666610718 00:22:18.577 --> 00:22:19.320 with surgery. NOTE Confidence: 0.8606657981872559 00:22:19.600 --> 00:22:23.759 They check various things and I'm, I'm sure Tina get NOTE Confidence: 0.8606657981872559 00:22:23.839 --> 00:22:27.599 into it, but you know, is your body well enough NOTE Confidence: 0.8606657981872559 00:22:27.679 --> 00:22:30.719 to endure a surgery of that magnitude? NOTE Confidence: 0.8973695635795593 00:22:31.080 --> 00:22:35.037 And so from there I got a pancreas and kidney NOTE Confidence: 0.8973695635795593 00:22:35.125 --> 00:22:40.489 transplant, which for the pancreas technically, and I like to NOTE Confidence: 0.8973695635795593 00:22:40.577 --> 00:22:44.622 do my air quotes, I don't have to take insulin NOTE Confidence: 0.8973695635795593 00:22:44.710 --> 00:22:50.690 because my, the transplanted kidney that I had transplanted pancreas NOTE Confidence: 0.8973695635795593 00:22:50.778 --> 00:22:53.679 that I have is producing insulin. NOTE Confidence: 0.920798659324646 00:22:55.240 --> 00:22:59.142 And so that kind of limits down my, my glucose NOTE Confidence: 0.920798659324646 00:22:59.227 --> 00:23:03.299 testing as well, even though I do get that every NOTE Confidence: 0.920798659324646 00:23:03.384 --> 00:23:07.796 two weeks, you know, my doctor visits and whatnot, I NOTE Confidence: 0.920798659324646 00:23:07.881 --> 00:23:11.359 got that the first kidney from a cadaver. NOTE Confidence: 0.8961911201477051 00:23:12.240 --> 00:23:18.649 And historically they don't last as long as the living NOTE Confidence: 0.8961911201477051 00:23:18.767 --> 00:23:19.480 donor. NOTE Confidence: 0.8692652583122253 00:23:20.119 --> 00:23:24.704 And so from that, that was done in June of NOTE Confidence: 0.8692652583122253 00:23:24.814 --> 00:23:25.359 2017. NOTE Confidence: 0.9515606760978699 00:23:26.040 --> 00:23:30.992 I got married in January of 2019 and I started NOTE Confidence: 0.9515606760978699 00:23:31.099 --> 00:23:34.759 seeing rejection around that time. NOTE Confidence: 0.8874513506889343 00:23:34.760 --> 00:23:41.471 And by August of 2020, we noticed the signs, March NOTE Confidence: 0.8874513506889343 00:23:41.606 --> 00:23:42.680 of 2019. NOTE Confidence: 0.846476137638092 00:23:42.680 --> 00:23:46.621 But by August of 2020, I was was back on NOTE Confidence: 0.846476137638092 00:23:46.719 --> 00:23:50.857 dialysis and I just as of May 17th of this NOTE Confidence: 0.846476137638092 00:23:50.956 --> 00:23:56.080 year, received a kidney from one of my best friends. NOTE Confidence: 0.9518617391586304 00:23:56.320 --> 00:23:59.601 And so I am doing all that I can to NOTE Confidence: 0.9518617391586304 00:23:59.695 --> 00:24:02.040 take care of this kidney. NOTE Confidence: 0.8799068927764893 00:24:02.440 --> 00:24:06.995 And even though I'm no longer quote UN quote diabetic NOTE Confidence: 0.8799068927764893 00:24:07.081 --> 00:24:10.520 per SE, I still function as though I am. NOTE Confidence: 0.8825202584266663 00:24:10.920 --> 00:24:13.419 So I'm not, even though I can, I'm not, you NOTE Confidence: 0.8825202584266663 00:24:13.477 --> 00:24:15.280 know, eating sweets like crazy. NOTE Confidence: 0.9301186800003052 00:24:15.640 --> 00:24:19.520 All I drink is water and medicine balls from Starbucks. NOTE Confidence: 0.8364925980567932 00:24:20.200 --> 00:24:23.031 You know, I don't really put anything I, I stay NOTE Confidence: 0.8364925980567932 00:24:23.091 --> 00:24:26.042 clear away from sodas, but I, I pretty much still NOTE Confidence: 0.8364925980567932 00:24:26.103 --> 00:24:29.175 function as though I was a diabetic because I don't NOTE Confidence: 0.8364925980567932 00:24:29.235 --> 00:24:30.439 want to return back. NOTE Confidence: 0.5484503507614136 00:24:30.760 --> 00:24:32.640 So yeah, sounds like you're. NOTE Confidence: 0.7656298279762268 00:24:33.120 --> 00:24:35.920 Extra careful so so Tina. NOTE Confidence: 0.9438193440437317 00:24:35.920 --> 00:24:36.160 Yeah. NOTE Confidence: 0.8665008544921875 00:24:36.160 --> 00:24:39.600 Who who's eligible for a kidney transplant and. NOTE Confidence: 0.9425196051597595 00:24:39.640 --> 00:24:40.480 And you know. NOTE Confidence: 0.9380210638046265 00:24:41.400 --> 00:24:42.920 Yeah, Yeah. NOTE Confidence: 0.7833358645439148 00:24:42.920 --> 00:24:43.520 I would love that. NOTE Confidence: 0.8893393874168396 00:24:43.560 --> 00:24:49.631 First, just to reiterate that with proper management, patients can, NOTE Confidence: 0.8893393874168396 00:24:49.721 --> 00:24:53.980 can really delay CKD to prevent to the point of NOTE Confidence: 0.8893393874168396 00:24:54.071 --> 00:24:56.880 needing dialysis or transplant. NOTE Confidence: 0.8525798916816711 00:24:56.880 --> 00:24:59.676 So that's that's the number one message is mainly your NOTE Confidence: 0.8525798916816711 00:24:59.728 --> 00:25:02.317 care and do all the things that we've been talking NOTE Confidence: 0.8525798916816711 00:25:02.369 --> 00:25:02.679 about. NOTE Confidence: 0.9536209106445312 00:25:02.680 --> 00:25:05.166 So you don't get to the place where you would NOTE Confidence: 0.9536209106445312 00:25:05.222 --> 00:25:06.880 be posed with such a question. NOTE Confidence: 0.812635600566864 00:25:07.200 --> 00:25:11.279 And then obviously these discussions should, should happen with your NOTE Confidence: 0.812635600566864 00:25:11.339 --> 00:25:13.679 healthcare providers and your position. NOTE Confidence: 0.8441804647445679 00:25:14.080 --> 00:25:17.352 But in general, you know, what we would love to NOTE Confidence: 0.8441804647445679 00:25:17.422 --> 00:25:21.599 see are patients receive what we call preemptive transplant. NOTE Confidence: 0.9639386534690857 00:25:21.600 --> 00:25:25.513 So they're able to be transplanted before they have a NOTE Confidence: 0.9639386534690857 00:25:25.587 --> 00:25:30.240 need for dialysis or another form of renal replacement therapy. NOTE Confidence: 0.8818361759185791 00:25:30.640 --> 00:25:35.204 And, and so there are many patients that are great NOTE Confidence: 0.8818361759185791 00:25:35.295 --> 00:25:37.759 candidates for transplants. NOTE Confidence: 0.9595029950141907 00:25:37.760 --> 00:25:41.005 And Tiffany spoke about the ability to get both a NOTE Confidence: 0.9595029950141907 00:25:41.072 --> 00:25:45.377 pancreatic transplant as well as a kidney transplant, which would NOTE Confidence: 0.9595029950141907 00:25:45.443 --> 00:25:46.040 be ideal. NOTE Confidence: 0.9552512764930725 00:25:46.440 --> 00:25:51.367 But there are some contraindications for those with to receive NOTE Confidence: 0.9552512764930725 00:25:51.446 --> 00:25:52.480 a transplant. NOTE Confidence: 0.86334627866745 00:25:52.480 --> 00:25:56.400 And so that might be like presence of a malignancy NOTE Confidence: 0.86334627866745 00:25:56.479 --> 00:26:00.399 or another type of of cancer and active infection. NOTE Confidence: 0.7967446446418762 00:26:00.400 --> 00:26:05.091 So might, might prohibit a, a transplant until that is NOTE Confidence: 0.7967446446418762 00:26:05.178 --> 00:26:05.959 resolved. NOTE Confidence: 0.9519174695014954 00:26:06.320 --> 00:26:09.760 Drug and alcohol dependency is a consideration. NOTE Confidence: 0.917660117149353 00:26:10.480 --> 00:26:13.986 And then even at times obesity or is, is another NOTE Confidence: 0.917660117149353 00:26:14.059 --> 00:26:17.930 consideration that we would need to think about as an NOTE Confidence: 0.917660117149353 00:26:18.003 --> 00:26:18.879 active plan. NOTE Confidence: 0.9290347099304199 00:26:19.720 --> 00:26:24.787 But in general, kidney transplants absolutely create a better quality NOTE Confidence: 0.9290347099304199 00:26:24.860 --> 00:26:28.238 of life and are more favorable in terms of not NOTE Confidence: 0.9290347099304199 00:26:28.312 --> 00:26:32.645 only quality of life, but survival statistics as it relates NOTE Confidence: 0.9290347099304199 00:26:32.718 --> 00:26:33.600 to dialysis. NOTE Confidence: 0.8875866532325745 00:26:34.080 --> 00:26:36.408 And so I would just encourage you again to have NOTE Confidence: 0.8875866532325745 00:26:36.458 --> 00:26:38.440 these conversations with your physician. NOTE Confidence: 0.8656070232391357 00:26:38.880 --> 00:26:42.125 You have an absolute right if when you get to NOTE Confidence: 0.8656070232391357 00:26:42.197 --> 00:26:45.876 the point of of needing this referral, but you have NOTE Confidence: 0.8656070232391357 00:26:45.948 --> 00:26:49.843 an absolute right to a referral to a transplant center NOTE Confidence: 0.8656070232391357 00:26:49.915 --> 00:26:52.440 and so and to a nephrologist early. NOTE Confidence: 0.9281226992607117 00:26:52.440 --> 00:26:56.273 And so I would engage in those conversations with your NOTE Confidence: 0.9281226992607117 00:26:56.344 --> 00:27:00.320 doctors so you can be evaluated for a transplant option. NOTE Confidence: 0.8776769042015076 00:27:00.640 --> 00:27:03.804 And if for some reason you you're not ready, then NOTE Confidence: 0.8776769042015076 00:27:03.868 --> 00:27:07.614 working with that healthcare team to develop a plan around NOTE Confidence: 0.8776769042015076 00:27:07.678 --> 00:27:10.843 obesity or whatever else it may be that you could NOTE Confidence: 0.8776769042015076 00:27:10.907 --> 00:27:14.201 actively work on for you to progress to be eligible NOTE Confidence: 0.8776769042015076 00:27:14.265 --> 00:27:15.880 for transplant over time. NOTE Confidence: 0.9373589754104614 00:27:17.000 --> 00:27:17.400 Great. NOTE Confidence: 0.950991690158844 00:27:17.440 --> 00:27:22.682 So people should consider the option of transplant if they NOTE Confidence: 0.950991690158844 00:27:22.772 --> 00:27:24.399 are at that point. NOTE Confidence: 0.9402359127998352 00:27:24.400 --> 00:27:27.797 And and again, the big message here is that all NOTE Confidence: 0.9402359127998352 00:27:27.869 --> 00:27:30.400 of this is potentially preventable. NOTE Confidence: 0.8835257291793823 00:27:30.400 --> 00:27:33.550 And so one of the questions that came out in NOTE Confidence: 0.8835257291793823 00:27:33.621 --> 00:27:37.488 the chat were we mentioned that you could do screening NOTE Confidence: 0.8835257291793823 00:27:37.559 --> 00:27:38.919 for kidney disease. NOTE Confidence: 0.8806222081184387 00:27:38.920 --> 00:27:41.439 People are concerned maybe they have kidney disease and they NOTE Confidence: 0.8806222081184387 00:27:41.481 --> 00:27:42.279 don't even know it. NOTE Confidence: 0.943148672580719 00:27:42.680 --> 00:27:44.280 So what should they ask for? NOTE Confidence: 0.9414194822311401 00:27:45.480 --> 00:27:48.449 Yeah, I think 2, two things that I would encourage NOTE Confidence: 0.9414194822311401 00:27:48.509 --> 00:27:49.399 you to ask for. NOTE Confidence: 0.8585913777351379 00:27:49.640 --> 00:27:54.411 One is a simple urine test that assesses what what's NOTE Confidence: 0.8585913777351379 00:27:54.503 --> 00:27:58.999 called albumin or protein presence in your urine. NOTE Confidence: 0.9613628387451172 00:27:59.000 --> 00:28:02.989 So if that is positive, that's abnormal and can indicate NOTE Confidence: 0.9613628387451172 00:28:03.061 --> 00:28:05.839 that you might have some kidney damage. NOTE Confidence: 0.8889431953430176 00:28:06.440 --> 00:28:10.310 The second is called is a blood test and it's NOTE Confidence: 0.8889431953430176 00:28:10.396 --> 00:28:16.245 called GFR which calculates your glomerular filtration rate which is NOTE Confidence: 0.8889431953430176 00:28:16.331 --> 00:28:20.718 inside of your kidneys and that's the the filter so NOTE Confidence: 0.8889431953430176 00:28:20.804 --> 00:28:25.105 to speak that kind of eliminates the waste and and NOTE Confidence: 0.8889431953430176 00:28:25.191 --> 00:28:29.320 fluids that we talked about earlier in the call. NOTE Confidence: 0.9222176671028137 00:28:29.640 --> 00:28:33.204 And so it's a simple blood test that will give NOTE Confidence: 0.9222176671028137 00:28:33.281 --> 00:28:36.691 you a number to your doctor as it relates to NOTE Confidence: 0.9222176671028137 00:28:36.768 --> 00:28:40.798 how your kidney is functioning and it will tell them NOTE Confidence: 0.9222176671028137 00:28:40.875 --> 00:28:44.827 when in fact you might be progressing to kidney and NOTE Confidence: 0.9222176671028137 00:28:44.905 --> 00:28:46.919 ultimately kidney failure. NOTE Confidence: 0.9522536396980286 00:28:47.160 --> 00:28:50.184 And then there are associated actions that should take during NOTE Confidence: 0.9522536396980286 00:28:50.234 --> 00:28:53.010 that time, like a referral to a nephrologist, A referral NOTE Confidence: 0.9522536396980286 00:28:53.060 --> 00:28:55.440 to a transplant center as we've been discussing. NOTE Confidence: 0.629281759262085 00:28:56.240 --> 00:28:56.520 Yep. NOTE Confidence: 0.8834156394004822 00:28:56.600 --> 00:29:00.444 So you're in for protein and GFR and you can NOTE Confidence: 0.8834156394004822 00:29:00.531 --> 00:29:03.239 get those pretty much anywhere. NOTE Confidence: 0.18793396651744843 00:29:03.760 --> 00:29:03.840 Wow. NOTE Confidence: 0.9175385236740112 00:29:04.080 --> 00:29:06.120 Like every lab does these tests. NOTE Confidence: 0.8481812477111816 00:29:06.120 --> 00:29:07.640 They're not, they're not unusual. NOTE Confidence: 0.8178489804267883 00:29:07.880 --> 00:29:08.080 Yeah. NOTE Confidence: 0.9152033925056458 00:29:08.240 --> 00:29:11.294 So if if you have diabetes and you haven't had NOTE Confidence: 0.9152033925056458 00:29:11.360 --> 00:29:14.879 those tests done, you should definitely ask for time. NOTE Confidence: 0.8806527256965637 00:29:14.880 --> 00:29:17.120 Is like we're we're moving really quickly here. NOTE Confidence: 0.8652837872505188 00:29:17.120 --> 00:29:18.560 This has been a great conversation. NOTE Confidence: 0.9599433541297913 00:29:18.560 --> 00:29:21.080 So we haven't been able to cover everything. NOTE Confidence: 0.916094958782196 00:29:21.080 --> 00:29:24.895 So Tina resources, if people want to learn more, they NOTE Confidence: 0.916094958782196 00:29:24.967 --> 00:29:28.999 want more support, they, they, they have more questions. NOTE Confidence: 0.8977483510971069 00:29:29.000 --> 00:29:31.243 We couldn't get to them all today, but maybe we'll NOTE Confidence: 0.8977483510971069 00:29:31.288 --> 00:29:32.319 do this again sometime. NOTE Confidence: 0.6277068853378296 00:29:32.320 --> 00:29:32.520 What? NOTE Confidence: 0.778997004032135 00:29:32.520 --> 00:29:33.400 Where can they go? NOTE Confidence: 0.9320882558822632 00:29:33.800 --> 00:29:34.240 For sure. NOTE Confidence: 0.7536359429359436 00:29:34.240 --> 00:29:35.200 And I know we're almost that time. NOTE Confidence: 0.9145625829696655 00:29:35.200 --> 00:29:36.040 So really quickly. NOTE Confidence: 0.9104019403457642 00:29:36.320 --> 00:29:38.800 diabetes.org absolutely. NOTE Confidence: 0.8784354329109192 00:29:38.800 --> 00:29:44.105 And I think it's diabetes.org/kidney is your your resource that NOTE Confidence: 0.8784354329109192 00:29:44.189 --> 00:29:49.999 includes both DaVita, so renal information plus diabetic information. NOTE Confidence: 0.8560462594032288 00:29:50.680 --> 00:29:54.378 So definitely that's number one number to is you can NOTE Confidence: 0.8560462594032288 00:29:54.449 --> 00:29:58.432 also visit divita.com which has a lot of resources there NOTE Confidence: 0.8560462594032288 00:29:58.504 --> 00:30:02.700 as well that's readily available for you to find additional NOTE Confidence: 0.8560462594032288 00:30:02.771 --> 00:30:06.399 resources as it relates to dietary needs as well as NOTE Confidence: 0.8560462594032288 00:30:06.470 --> 00:30:08.959 kidney community education classes. NOTE Confidence: 0.896369218826294 00:30:09.800 --> 00:30:12.560 Great, so there's lots of information out there. NOTE Confidence: 0.8875672221183777 00:30:12.880 --> 00:30:16.040 Go to reliable sources like the ones you described. NOTE Confidence: 0.9233605265617371 00:30:16.480 --> 00:30:20.280 We'll throw those into the comments. NOTE Confidence: 0.939010500907898 00:30:20.280 --> 00:30:23.240 And and I think we need to wrap up here. NOTE Confidence: 0.845638632774353 00:30:23.240 --> 00:30:26.965 So maybe I'll, I'll, I'll ask each of you for NOTE Confidence: 0.845638632774353 00:30:27.048 --> 00:30:30.691 sort of a, a final thought to share with the NOTE Confidence: 0.845638632774353 00:30:30.774 --> 00:30:31.519 audience. NOTE Confidence: 0.9477816820144653 00:30:31.880 --> 00:30:32.240 So. NOTE Confidence: 0.8237184882164001 00:30:32.320 --> 00:30:35.871 So let's start with you, Tiffany, and then we'll, we'll NOTE Confidence: 0.8237184882164001 00:30:35.936 --> 00:30:36.840 let you, yeah. NOTE Confidence: 0.9124796390533447 00:30:39.480 --> 00:30:42.738 For the most part, don't look at diabetes as you NOTE Confidence: 0.9124796390533447 00:30:42.806 --> 00:30:46.199 know, just something that's impeding on your life. NOTE Confidence: 0.8855812549591064 00:30:46.200 --> 00:30:51.760 Just look at it as another managed opportunity. NOTE Confidence: 0.898737370967865 00:30:52.000 --> 00:30:55.179 You know, just as you would change your lifestyle to NOTE Confidence: 0.898737370967865 00:30:55.240 --> 00:30:58.176 a healthy 1 in order, like you know, working out NOTE Confidence: 0.898737370967865 00:30:58.237 --> 00:31:01.050 or you know what foods you know keto diet, you NOTE Confidence: 0.898737370967865 00:31:01.111 --> 00:31:02.639 know all of those things. NOTE Confidence: 0.8389284014701843 00:31:03.000 --> 00:31:06.385 Just think of it as another component just to maintain NOTE Confidence: 0.8389284014701843 00:31:06.447 --> 00:31:09.582 your life and just find ways to incorporate it and NOTE Confidence: 0.8389284014701843 00:31:09.644 --> 00:31:12.841 not look so much at it as something that's impeding NOTE Confidence: 0.8389284014701843 00:31:12.904 --> 00:31:15.349 on, on who you are and what you want to NOTE Confidence: 0.8389284014701843 00:31:15.411 --> 00:31:15.600 do. NOTE Confidence: 0.8211532831192017 00:31:15.840 --> 00:31:17.240 It's, it's manageable. NOTE Confidence: 0.911754846572876 00:31:17.760 --> 00:31:19.400 You can, you can beat it. NOTE Confidence: 0.9466661810874939 00:31:19.560 --> 00:31:21.996 You do not have to end up like I did NOTE Confidence: 0.9466661810874939 00:31:22.063 --> 00:31:26.191 being blind going through 2 transplants, 2 types of dialysis, NOTE Confidence: 0.9466661810874939 00:31:26.259 --> 00:31:28.559 you know, affecting my loved ones. NOTE Confidence: 0.8618831038475037 00:31:28.840 --> 00:31:30.920 It's completely preventable. NOTE Confidence: 0.9176824688911438 00:31:32.720 --> 00:31:36.633 Thanks for your service to the community to tell your NOTE Confidence: 0.9176824688911438 00:31:36.707 --> 00:31:37.520 your story. NOTE Confidence: 0.9282914996147156 00:31:37.520 --> 00:31:38.880 Tina final words. NOTE Confidence: 0.8600779175758362 00:31:39.800 --> 00:31:42.466 I, I, I think Tiffany said it all, I would NOTE Confidence: 0.8600779175758362 00:31:42.529 --> 00:31:46.719 just reiterate that this is completely manageable and preventable. NOTE Confidence: 0.9259247779846191 00:31:46.720 --> 00:31:49.959 And so my one word of advice, I guess, would NOTE Confidence: 0.9259247779846191 00:31:50.033 --> 00:31:53.862 be get smart about your risk factors, the actions as NOTE Confidence: 0.9259247779846191 00:31:53.935 --> 00:31:58.501 we've been discussing that you can take to prevent progression NOTE Confidence: 0.9259247779846191 00:31:58.574 --> 00:32:01.519 to CKD and use the resources around you. NOTE Confidence: 0.9093559384346008 00:32:01.520 --> 00:32:03.240 They're, they're really abundant. NOTE Confidence: 0.9169818162918091 00:32:03.240 --> 00:32:06.681 And so take advantage of that to help you kind NOTE Confidence: 0.9169818162918091 00:32:06.755 --> 00:32:08.999 of navigate your path forward. NOTE Confidence: 0.8956672549247742 00:32:10.320 --> 00:32:10.680 Great. NOTE Confidence: 0.7751485109329224 00:32:11.160 --> 00:32:16.512 And reminder, diabetes.org/kidney you should see in the in the NOTE Confidence: 0.7751485109329224 00:32:16.599 --> 00:32:19.880 comments section For more information. NOTE Confidence: 0.8202231526374817 00:32:19.880 --> 00:32:21.840 This has been ADA dialogue. NOTE Confidence: 0.9537739753723145 00:32:22.440 --> 00:32:24.400 Thank you both for joining us. NOTE Confidence: 0.9569917917251587 00:32:24.400 --> 00:32:27.640 Thank the audience and we will be posting this. NOTE Confidence: 0.9186142683029175 00:32:27.640 --> 00:32:30.287 So if a loved one or a friend that you NOTE Confidence: 0.9186142683029175 00:32:30.357 --> 00:32:34.397 think would benefit from this program, share it and again, NOTE Confidence: 0.9186142683029175 00:32:34.467 --> 00:32:36.000 see you all next time. NOTE Confidence: 0.9674023985862732 00:32:36.000 --> 00:32:37.000 Thanks everyone.