After all of the ups and downs lately, I’ll take a morning like that without complaint.
Nephrologist Appointment Today
I had my nephrology appointment today, and it was very encouraging.
He examined me and didn’t see any signs of fluid retention.
That is definitely a plus.
After the recent weight fluctuations, swelling, and concern about whether I was holding onto fluid again, hearing that was reassuring.
We also talked about the MRI I have scheduled for Monday.
I’ve obviously been anxious about it.
He reviewed my kidney ultrasound again and told me not to sweat it.
His explanation actually helped.
He compared the ultrasound to looking at something from a distance.
You can see the general picture, but you can’t necessarily see all of the fine details.
The MRI is more like getting up close.
It will allow them to look at everything in much greater detail and hopefully answer the remaining questions.
That made the whole thing feel a little less ominous.
It sounds like the MRI is really about making sure they have the clearest possible picture.
Either way, I get it done Monday.
Hopefully, after that, we can finally start putting this whole AKI episode behind me.
I Want to Write More About the AKI
Once I get through all of this, I’m planning to write a full article about my acute kidney injury.
Not because I think everyone’s experience will be the same as mine.
It won’t.
But I think there is value in explaining what happened to me, how quickly my kidney numbers changed, what contributed to it, what my doctors looked for, and what I learned from the experience.
Before this happened, I knew what an AKI was in general terms.
I didn’t really understand how quickly it could happen or how something being used to help one medical condition could potentially create a problem somewhere else.
That balancing act has probably been one of the biggest lessons of this entire experience.
The Radiology Instructions
The radiology department also called with instructions for Monday.
One of the instructions is that I need to drink 32 ounces of water about 30 minutes before the MRI.
That kind of sucks.
With the fluid limit I normally follow, 32 ounces is a huge chunk of my daily allowance.
It’s a little over 60 percent of what I normally drink in an entire day.
So I’m going to have to plan around that.
This isn’t me deciding to suddenly increase my fluid intake. These are the instructions I was given for the test, and I’ll follow the instructions from the people taking care of me.
At this point, I just want to get the MRI done and get some answers.
Anxious and Optimistic
Even with a very reassuring appointment today, I’m still anxious.
I think that is probably going to be there until the MRI is finished and someone tells me exactly what they see.
But I’m also optimistic.
My health numbers were good this morning.
My weight is still moving in the right direction.
My nephrologist didn’t see any signs of fluid retention.
And he didn’t seem overly concerned about what he saw on the ultrasound.
Those are all positives.
So Monday is the next hurdle.
Get the MRI.
Get the results.
And hopefully put one more medical scare in the rearview mirror.
Medical Disclaimer
This journal reflects my personal health experience and the treatment and testing plan developed specifically for me by my healthcare providers. Nothing in this article should be considered medical advice, diagnosis, or a recommendation to change your medications, fluid intake, sodium intake, testing, or treatment. Instructions for imaging studies, including how much fluid to drink before an MRI or other procedure, may vary depending on the test and the individual patient. Always follow the instructions provided by your own healthcare team and radiology department. Acute kidney injury, fluid retention, changes in kidney function, and related symptoms can have many different causes and should be evaluated by qualified healthcare professionals.
That puts me just 25 pounds away from my goal of 225 by April.
After the fluid issues I was watching over the last few days, it was also reassuring to see my body-water measurement back in its normal range.
My blood pressure was good.
My heart rate was good.
My glucose was good.
For once, everything seemed to be cooperating.
I’ll take that kind of morning anytime.
I’m Going to Start Tracking My Food Here
I think I’m going to make a small change to the Daily Journal going forward.
I want to start adding a section where I record what I ate during the previous day.
I’m not trying to calculate every calorie or milligram of sodium with laboratory precision. What I really want is a simple record I can go back and look at.
If I suddenly gain two or three pounds, my feet swell, or my body-water reading jumps, I want to be able to look back and say:
What did I eat yesterday?
Was there something unusually high in sodium?
Did I eat something different?
Was there a restaurant meal, sauce, dressing, packaged food, or something else I didn’t think about at the time?
That’s really all I need.
Something close enough to help me identify patterns.
I’ve Tried the Food Tracking Apps
I’ve tried quite a few food-tracking apps over the years.
Some are pretty good.
Some are not.
And some, in my experience, have been a complete waste of money.
My worst experience was with CAL AI.
When I first started using it, I actually liked it.
It worked well.
I could enter what I was eating, and it gave me the kind of quick estimate I was looking for.
Then, about 30 days into using it, the app suddenly stopped working properly.
It would no longer record the food I entered.
I contacted the company for support.
That didn’t get me very far.
My experience was basically an AI support bot giving me the same response over and over again without actually fixing the problem.
I eventually asked for a refund.
That didn’t happen either.
So I disputed the charge with my credit card company.
The company challenged the dispute, and in the end I was left without a refund and without a working application.
So that was fun.
The really funny part is that I wouldn’t be shocked if I somehow get charged again when the membership renews.
At this point, I think keeping my own simple food record right here might actually work better for what I need.
Yesterday’s Food
Going forward, I think I’ll keep this part intentionally simple.
I’m not trying to turn this into a calorie-counting diary.
I just want another piece of information I can compare with my weight, swelling, blood pressure, body-water readings, and how I’m feeling.
Over time, maybe I’ll start seeing patterns that aren’t obvious in the moment.
Still Staying Out of the Heat
It’s still hot here.
Another heat advisory today.
So I’m continuing to stay inside and out of the heat as much as possible.
With the lightheadedness and near-passing-out episodes I’ve had, I don’t see any reason to tempt fate by spending time outside when the temperature and humidity are brutal.
There will be plenty of time to go outside when Florida decides to stop trying to cook us.
Kidney Appointment Tomorrow
Tomorrow is my nephrology appointment.
Since the renal blood work somehow wasn’t done with the rest of my labs, I’m expecting there’s a pretty good chance I’ll need another blood draw.
That may be especially important because my MRI on Monday is scheduled with contrast, and they may want updated kidney-function numbers before giving it to me.
So I’m guessing there are probably a few more needles in my immediate future.
At this point, I should probably start earning frequent-flyer miles for blood draws.
Still, today started on a good note.
250 pounds.
Body water back to normal.
Good blood pressure.
Good heart rate.
Good glucose.
Tomorrow we deal with the kidneys.
Today, I’m enjoying the good numbers.
Medical Disclaimer
This journal reflects my personal experiences managing multiple chronic health conditions and the treatment plan developed specifically for me by my healthcare providers. Nothing in this article should be considered medical advice, diagnosis, or a recommendation to change your diet, medications, fluid intake, testing, or treatment plan. Weight changes, swelling, abnormal heart rate or blood pressure, changes in kidney function, and other symptoms can have many different causes. Dietary sodium and fluid recommendations can also vary significantly from person to person depending on their medical conditions and medications. Always discuss symptoms, medication changes, dietary restrictions, imaging with contrast, and other medical decisions with your own qualified healthcare professionals.
I’m down three pounds from yesterday, which pretty much confirms what I suspected yesterday — I definitely had some fluid buildup.
That’s good news.
My blood pressure was still slightly high, and my pulse was significantly elevated. I’m not really sure why. I had been sitting and resting before I took the reading, so it wasn’t like I had just been walking around or doing anything strenuous.
I’m still dealing with some anxiety about all of the testing coming up, so maybe that is playing a role. I honestly don’t know.
For now, I’m watching it.
Another Near-Passing-Out Episode
I also had another episode yesterday that got my attention.
I was getting out of my recliner to go eat dinner when I suddenly became extremely lightheaded. My vision started closing in — that tunnel-vision feeling — and for a moment I really thought I was going to pass out.
I didn’t.
Thankfully, this episode passed pretty quickly. Within a few moments, I was feeling better.
It also felt different from some of the other episodes I’ve had. I wasn’t sweaty this time, and it didn’t linger nearly as long.
My first thought was that maybe my blood pressure dropped when I stood up too quickly. That would make sense, but that is only my guess. With everything else going on, I’m not going to pretend I know exactly what caused it.
It is another thing I’ll be mentioning to my medical team.
These are the kinds of symptoms that make all of the tracking feel worthwhile. If something happens, I can look back at my blood pressure, pulse, weight, medications and everything else instead of trying to remember it later.
The Blood Work Came Back… Mostly
I received the results from my blood tests.
Well, most of them.
I had something like eight different tests ordered, but somehow the renal blood work wasn’t run.
Of course.
That’s probably the test I’m most interested in right now.
I’m guessing the person who drew my blood somehow missed that order. I have my nephrology appointment on Thursday, so there is a pretty good chance I’ll end up having it drawn after the appointment.
It’s frustrating because, with everything that has been going on with my kidneys, those are the numbers I really wanted to see.
But there was another result I had been anxiously waiting for.
My PSA.
And thankfully, it was normal.
One Less Thing to Freak Out About
Prostate cancer runs in my family, so I was definitely jonesing for that PSA result.
Between the recent acute kidney injury and the blood I had in my urine, my mind had already gone down every possible road.
That’s what anxiety does.
You know there are probably several explanations for something, but your brain immediately starts working its way toward the worst one.
So seeing a normal PSA was a relief.
One less thing to worry about.
I still need additional testing on my bladder, though.
And there is one procedure in particular that I am not exactly rushing to schedule.
The Cystoscopy
Eventually I need to have a cystoscopy.
A cystoscopy is a procedure where a doctor uses a thin, lighted tube called a cystoscope to look inside the urethra and bladder.
Yep.
That means it goes from the outside into the bladder.
There is really only one route available for that journey.
Let’s just say I am not terribly excited about it.
I’m planning to wait until after my hip surgery before dealing with that one.
Is that partly because I have other medical priorities right now?
Absolutely.
Is it also because the procedure sounds like about as much fun as you would imagine?
Absolutely.
The Next Few Days
So now the schedule looks like this:
Nephrologist on Thursday.
MRI on Monday.
Hopefully, between those appointments and the missing renal blood work eventually getting done, we’ll have a much better idea of where things stand with my kidneys.
My hope is that we can finally put this AKI behind me.
Yesterday I was worried about fluid buildup and had another near-passing-out episode.
Today I’m three pounds lighter.
The PSA was normal.
There are still unanswered questions, but at least this morning there are a couple of things moving in the right direction.
I’ll take the wins when I can get them.
Medical Disclaimer
This journal documents my personal health experiences and the treatment plan developed specifically for me by my healthcare providers. Nothing in this article is medical advice or a recommendation to diagnose, treat, monitor, delay, or change the treatment of any medical condition. Symptoms such as rapid weight changes, swelling, elevated heart rate, dizziness, tunnel vision, fainting or near-fainting, blood in the urine, or changes in kidney function can have many causes, including potentially serious ones, and should be evaluated by qualified healthcare professionals. Do not assume that symptoms similar to mine have the same cause, and do not change medications or delay recommended testing or treatment based on anything you read here. Seek prompt medical attention for new, severe, persistent, or worsening symptoms, especially actual fainting, chest pain, significant shortness of breath, new neurological symptoms, or other symptoms that concern you. Always discuss your individual situation with your own healthcare team.
My morning health check was about as good as it has been the last couple of days, but one thing caught my attention.
I gained a pound since yesterday.
Normally, a one-pound change by itself probably wouldn’t alarm me too much. What concerned me was that I really didn’t eat much yesterday. I had a salad for dinner. It wasn’t a small salad, but it certainly wasn’t anything that should have caused me to gain a pound overnight.
Then I started looking at everything else.
My feet were slightly swollen.
My blood pressure was up.
My body-water calculation was also higher.
Put all of that together,
and I started wondering if I was retaining fluid again.
So I took a Torsemide this morning.
I only take my diuretic on an as-needed basis now. That was a decision made with my medical team, not something I decided to do on my own.
I manage my sodium and fluid intake very tightly because my goal is to avoid needing diuretics whenever possible. My doctors have actually seen the Excel spreadsheet I use to track everything. I don’t miss days. I document changes, symptoms, weight, blood pressure and medication adjustments made by my medical team.
That level of tracking became especially important after what happened a few months ago.
When Too Much Diuretic Became a Problem
A few months ago, I ended up in the hospital after becoming over-diuresed.
Basically, my body had gotten too low on fluid while I was still taking my diuretics as prescribed.
That contributed to an acute kidney injury, or AKI.
My kidney function dropped significantly. An eGFR above 60 is generally considered a better range, and mine had fallen into the low 30s.
That episode is part of the reason I later had a kidney ultrasound and why I now have an MRI scheduled.
After several appointments with my nephrologist, and after my doctors saw just how closely I was monitoring everything, my diuretic plan was changed to as-needed use.
That gives me a little more flexibility, but it also means I have to pay close attention to what my body is telling me.
And lately, I am.
Why This Morning Has Me Concerned
This is now the second time in about a week that I’ve noticed signs that make me wonder if I’m holding onto more fluid than I should.
What makes it frustrating is that I can’t immediately point to something obvious.
I didn’t have shrimp in my salad.
It was basically vegetables, other than the dressing.
So my next step is to retrace everything I ate and drank yesterday and see if something contained more sodium than I realized.
Sometimes that’s all you can do.
Go back.
Look at the numbers.
Then at what you ate.
Also at what you drank.
And try to find the missing piece.
Blood Work Today
I also have a blood draw today.
A few hours after that, I’ll have a new set of numbers to look at.
And I’ll admit it: I’m having a lot of anxiety about it.
After watching my kidney function drop before, it’s hard not to worry about what those lab results are going to show.
I’m praying everything looks good.
If it doesn’t, then there may be more changes ahead.
Either way, I’ll know more soon.
And when I do, I’ll let you know.
Medical Disclaimer
This journal reflects my personal experience living with heart failure, kidney disease, and the treatment plan developed specifically for me by my healthcare team. Nothing in this article should be taken as medical advice or as a recommendation to start, stop, skip, increase, decrease, or otherwise change any medication, including diuretics. Diuretics can affect fluid balance, blood pressure, electrolytes, and kidney function, and improper use can be dangerous. Any changes to your medications, fluid intake, sodium limits, or treatment plan should be made only in consultation with your own qualified healthcare professionals. If you experience new or worsening swelling, rapid weight changes, shortness of breath, chest pain, severe dizziness, fainting, or other concerning symptoms, seek appropriate medical care promptly.
My morning health checks are continuing to trend in the right direction.
Finally.
My weight has stabilized and I’ve even lost a little more. I’m still working toward my goal of 225 pounds by April 2027, so I’ll happily take a loss when it’s the kind I’m actually trying to achieve.
My blood pressure was normal this morning.
My body-water percentage was unchanged from yesterday.
And maybe most importantly after what I’ve been watching over the last few days:
No swelling in my feet today.
Weight stable.
Blood pressure good.
Body water stable.
No swelling.
All of those signs tell me that I’m pretty much back to my version of “normal.”
Physically, that’s great news.
Mentally?
That’s a little more complicated.
Now I Have to Convince Myself It’s Okay to Eat and Drink
After watching my weight climb and seeing the swelling in my feet, I became extremely cautious about what I was eating and drinking.
Maybe too cautious.
Truth be told, I didn’t eat or drink normally yesterday.
I drank because I know my kidneys need hydration.
I ate because I know I need enough food to keep my blood sugar from dropping.
But I can’t say I was comfortable doing either one.
That’s something I’m still working on.
Logically, I understand that my body needs food and fluid.
Emotionally, there’s another voice saying:
Remember what happens when this goes wrong.
Because the thing I really want to avoid is another hospitalization.
I Really Hate Hospitals
I don’t just dislike being hospitalized.
I hate it.
It’s incredibly difficult for me to stay positive when I’m in the hospital.
Part of that is everything that comes with being sick enough to be there in the first place.
But there’s something else.
I’m kind of a germ freak.
Okay…
I’m definitely a germ freak.
I practiced social distancing before COVID made it fashionable.
When I was working, I’d walk around with Lysol wipes cleaning things.
Door knobs.
Conference tables.
Chairs.
Elevator buttons.
Handrails.
Basically, if another human being had touched it, there was a decent chance I was coming behind them with a disinfecting wipe.
A little insane?
Probably.
But I rarely got sick.
So you can probably imagine how I feel about hospitals.
They’re full of sick people.
There are germs everywhere.
There are diseases I didn’t even know existed until somebody put me in a room next to one.
That part of being hospitalized genuinely freaks me out.
And unfortunately, I have a pretty good reason for feeling that way.
Then There Was C. Diff
After one of my hospital stays, I ended up back home only to develop C. diff shortly afterward.
At that point in my life, I was barely leaving the house because of everything else going on with my health.
Where exactly I picked it up isn’t something I can prove, but the timing certainly made that hospital stay stand out in my mind.
If you’ve never experienced C. diff…
Consider yourself lucky.
It was awful.
It even threatened to interfere with the timing of my heart procedure.
At the time, there was absolutely nothing funny about it.
Now?
Well…
Enough time has passed that I can find some humor in the experience.
That might eventually become a Living With It article.
Although I’m not entirely sure the internet is ready for that one.
So Yeah, I’m Afraid of Going Back
All of that helps explain why a couple pounds of weight gain and some swelling can mess with my head.
It’s not simply:
Oh, my weight went up.
My brain immediately starts working its way down the road:
Weight gain.
Fluid retention.
Heart failure.
Diuretics.
Is it getting worse?
Do I need to call somebody?
Am I going back to the hospital?
That’s what I’m trying to get better at managing.
My morning health checks are supposed to give me information.
They’re supposed to help me make informed decisions and recognize trends.
I don’t want them to become something that makes me afraid to eat.
There’s a balance there that I haven’t completely figured out yet.
Meanwhile, Welcome to August in Southwest Florida
Life itself has been pretty boring lately.
It’s August in Southwest Florida.
Which basically means:
It’s hot.
Really hot.
And I’ve been trying to stay out of it.
I’ve had several episodes recently where I’ve become extremely lightheaded and started sweating profusely, particularly with exertion and heat.
One of them happened while I was simply cooking on the grill.
I wasn’t running a marathon.
I wasn’t doing yard work.
I was making dinner.
Suddenly, I became so lightheaded that I genuinely thought I might face-plant.
When that happens, I’m done.
I sit down.
I cool off.
And it can take about 20 minutes before I start feeling normal again.
That’s something I’m already working with my doctors to understand.
Until we have better answers, I’m not going to prove how tough I am by standing outside in the Florida heat.
The grill will survive without me.
❤️ Greg’s Take
Physically, today was a good morning.
Actually, it was probably exactly what I wanted to see.
My weight has stabilized.
My blood pressure looks good.
My body-water percentage isn’t climbing.
And the swelling in my feet is gone.
That’s a win.
Now I have to work on the other part.
Trusting my body enough to eat.
Trusting myself enough to drink what I’m supposed to drink.
And using my morning health checks as information rather than letting every change scare me into thinking I’m headed back to the hospital.
That’s easier said than done.
I’ve had enough hospital stays that avoiding another one has become a pretty powerful motivator.
Sometimes maybe too powerful.
But that’s part of living with all of this too.
Not every recovery happens on a scale.
Sometimes the numbers return to normal before your head does.
Today, my numbers look pretty good.
Now I need to work on catching up with them.
Medical Disclaimer
This daily journal describes my personal experiences managing chronic health conditions and is not medical advice. My monitoring routine, diet, fluid intake and medications are based on guidance from my own healthcare team. Everyone’s medical needs are different. If you have heart failure, kidney disease, diabetes or another chronic condition, talk with your healthcare team about appropriate fluid, nutrition, weight and symptom-monitoring goals for you.
My morning health checks were much better today than they were the previous two days.
And I’m definitely happy to see that.
I dropped a little over three pounds since yesterday, bringing my weight back down to about where it should be. Considering the weight gain, increased body water and swelling I was seeing over the last couple of days, it certainly looks like I had been retaining fluid.
My blood pressure was also lower this morning at 114/68 with a pulse of 57.
That’s lower than yesterday, but not something I’m particularly concerned about based on how I’m feeling. It’s simply another number I’m going to continue watching.
My feet also look almost normal again.
I think there’s still a little swelling because they feel somewhat stiff, but there’s a noticeable improvement. Yesterday, they actually hurt.
Today is definitely a better day.
This Is Why I Do Morning Health Checks
Days like today reinforce why I’ve become so committed to doing these checks every morning.
It can seem like a hassle.
Get on the scale.
Check my blood pressure and pulse.
Look at the body-water reading from my BIA scale.
Check my feet and legs for swelling.
Pay attention to how I’m feeling.
Record everything.
Then do it all over again tomorrow.
But there’s a reason I do it.
I’m trying to catch changes early rather than waiting until I’m sick enough to end up back in the hospital.
Yesterday, several things were moving in the wrong direction at the same time.
My weight was up for the second consecutive day. My BIA scale showed increased body water. My blood pressure was a little higher, and I could see swelling in my feet.
Today, most of those things are moving back toward normal.
That’s exactly the kind of trend I’m looking for.
A Good Day Doesn’t Mean I Stop Monitoring
It would be easy to look at today’s three-pound drop and think:
Great. Problem solved.
Not quite.
My feet still appear to be slightly swollen.
And more importantly, I still don’t know exactly what caused the fluid retention in the first place.
Was it too much sodium?
Was there more sodium in the shrimp I ate than I realized?
Did the fruit I ate add enough additional fluid to make a difference?
Was it a combination of several small things?
Or is something happening with my heart that has absolutely nothing to do with anything I ate or drank?
I don’t know.
And that’s exactly why I can’t stop monitoring just because today’s numbers look better.
Sometimes There Isn’t an Obvious Answer
I think that’s one of the frustrating parts of managing a chronic illness.
I want there to be a simple cause and effect.
I did X, so Y happened.
Unfortunately, the body doesn’t always cooperate with that logic.
I can retrace everything I ate.
I can look at how much I drank.
I can check nutrition labels.
I can look at my activity.
And sometimes I still won’t have a definite answer.
What I can do is continue collecting information.
If something starts changing again tomorrow, I’ll know.
If my weight continues downward and the swelling disappears, I’ll know that too.
The individual number matters.
The trend matters even more.
The Goal Is Staying Out of the Hospital
I’ve spent enough time in hospitals.
If taking a few minutes every morning to check my weight, blood pressure, pulse, body water and swelling gives me a better chance of catching a problem early, those few minutes are absolutely worth it.
Are morning health checks sometimes annoying?
Yep.
Would I occasionally rather just grab a cup of coffee and forget about all of it?
Absolutely.
But I also know the alternative.
A few minutes checking numbers at home sounds a whole lot better than spending several days checking the ceiling from a hospital bed.
So tomorrow morning I’ll do it all again.
Even though today’s numbers were better.
Especially because today’s numbers were better.
I want to know they stay that way.
❤️ Greg’s Take
Yesterday was a little concerning.
Today was encouraging.
But neither day tells the entire story by itself.
That’s what I’m learning from tracking my health every morning.
One bad number doesn’t necessarily mean disaster.
And one good number doesn’t necessarily mean everything is fixed.
It’s the pattern I’m watching.
Today, I’m more comfortable knowing my weight has come back down, my feet look considerably better and most of the signs I was watching are moving in the right direction.
I’ll take that win.
But tomorrow morning, I’ll still step on that scale.
I’ll still check my blood pressure.
I’ll still look at my feet.
And I’ll still write everything down.
Because as much of a pain as this routine can sometimes be, I know which is worse:
Five minutes of morning health checks or another few days in the hospital.
Well, my morning health checks are continuing to move in the wrong direction.
I gained more than a pound again this morning. That’s now two days in a row with a gain of more than a pound.
This time, there were some other signs along with it.
My BIA scale showed an increase in body water. My blood pressure was slightly elevated, and when I looked at my feet, I could see some mild swelling.
One number by itself might not concern me much.
Several things pointing in the same direction get my attention.
It looks like I’m retaining fluid.
First Things First
The first thing I did was follow the plan my cardiologist has given me and take my prescribed diuretic.
Anyone who has dealt with heart failure and diuretics probably knows what that means.
A good portion of today’s schedule will revolve around knowing exactly where the nearest bathroom is.
Not particularly exciting, but that’s part of managing this.
Now I watch what happens.
Does the swelling decrease?
Does my weight start moving back down?
Does the extra water come off?
Tomorrow morning’s numbers will be especially interesting.
Now Comes the Detective Work
The next thing I do when this happens is start retracing my steps.
What changed?
Did I drink too much?
I don’t think so. I didn’t have any extra water yesterday. I did have a couple of peaches, which obviously contain water, but I don’t think that alone explains what I’m seeing.
Then I started thinking about dinner from a couple of nights ago.
The steak and shrimp rice bowls.
They were one of my favorite meals, and I’ll admit it:
I overindulged.
The meal itself wasn’t necessarily the problem. We make it at home, so I have a pretty good idea of what’s going into the steak, rice, vegetables and seasonings.
The question mark is the shrimp.
Shrimp Can Be Tricky
Shrimp naturally contains some sodium, but packaged shrimp can contain considerably more depending on how it was processed.
Unfortunately, we already threw away the package.
So I can’t go back and check the label.
That’s frustrating because I’d really like to know exactly what I ate.
Maybe we bought a different shrimp than usual. Maybe it contained more sodium from processing or packaging. Maybe the larger portion I ate was enough to push me over the edge.
Or maybe it wasn’t the shrimp at all.
I don’t know.
That’s important for me to say because it’s very easy to see the scale move and immediately blame the last suspicious thing I ate.
All I can do is look at the information I have and try to identify the most likely explanation.
Maybe Fresh Shrimp Is the Better Answer
One thing I’m considering going forward is buying more of our shrimp fresh from a seafood market.
Living in Southwest Florida, we’re certainly not lacking seafood markets.
That would give me another option when I’m trying to avoid some of the sodium that can be added during processing.
But even then, I’ll still need to ask questions and pay attention to what I’m buying. “Fresh” doesn’t automatically tell me everything about how seafood was handled before it reached the counter.
That’s one lesson I keep learning:
Never assume. Ask. Read. Check.
Sodium Doesn’t Always Give Me an Immediate Warning
This is one of the frustrating parts of tracking everything.
I don’t necessarily eat something salty at dinner and wake up the next morning several pounds heavier.
Sometimes the pattern takes longer to become apparent.
That’s why looking at trends has become more useful to me than reacting to one isolated number.
Yesterday I was up.
Today I’m up again.
Now I’m also seeing increased body water on the scale and some swelling in my feet.
That’s a trend worth paying attention to.
I’m Watching — Not Panicking
I’m still nowhere near the point where I think I need to head to the hospital.
But I’m also not ignoring what’s happening.
I’ve followed the medication plan my cardiologist gave me, and now I’ll monitor things more closely.
That’s really what all of this daily tracking is about.
It’s not about panicking every time the scale moves.
It’s about noticing when several things start changing together and knowing when I need to pay closer attention.
Hopefully, the diuretic does what it’s supposed to do today.
Hopefully, the swelling improves.
And hopefully tomorrow morning I step on the scale and finally see that number traveling in the other direction.
❤️ Greg’s Take
This is exactly why I do morning health checks every day.
Yesterday’s weight gain was something to watch.
Today’s second consecutive gain, increased body water, slightly swollen feet and higher blood pressure gave me more information.
Now I can respond according to the plan my cardiologist has already given me instead of waiting until things get significantly worse.
I may never know whether those delicious steak and shrimp rice bowls were responsible.
But I learned something anyway.
Next time, don’t throw away the shrimp package until after I’ve survived the meal.
And maybe don’t eat quite so much of it either.
That second lesson may be the harder one.
Medical Disclaimer: This journal reflects my personal experience living with chronic illness and how I manage my health based on guidance from my own healthcare team. It is not medical advice. Medications, including diuretics, should only be taken as prescribed by your healthcare provider. If you notice changes in your weight, swelling, blood pressure, breathing, or other symptoms, contact your healthcare provider for guidance. Seek immediate medical attention for symptoms that may be an emergency.
One of the biggest lessons I’ve learned is that “low sodium” doesn’t automatically mean “eat as much as you want.”
Sometimes solving one dietary problem creates another thing you still have to pay attention to.
That has been especially true for me because I’m not managing just one chronic illness.
I’m trying to balance congestive heart failure, chronic kidney disease, and diabetes at the same time.
And some days, honestly, it feels like the rules contradict each other.
Low Sodium Is Only One Piece of the Puzzle
Because of my heart failure, sodium is something I pay very close attention to. Too much sodium can contribute to fluid retention, which is one reason people with heart failure may be advised to limit sodium and, in some cases, fluids. The exact limits should come from your healthcare team.
But sodium isn’t the only number that matters to me.
Carbohydrates are another big one because I also have diabetes.
Lately, my carbohydrate intake has actually been very well controlled.
Unfortunately, part of the reason is something I’m not particularly proud of:
I’m sometimes afraid to eat or drink too much.
I know that sounds messed up.
But after being hospitalized multiple times, the fear is real.
Why I’m So Determined to Stay Out of the Hospital
Hospital stays are particularly difficult for me because of my mobility problems.
My right hip is bone-on-bone, and I use a walker. That makes me a fall risk.
When I’m hospitalized, that usually means bed or chair alarms. If I need to get up, I’m supposed to call for assistance.
That sounds reasonable until you’re receiving IV diuretics.
When those medications start working and you need to use the bathroom, sometimes you need to go now.
Waiting for someone to arrive, turn off the alarm, and help you up can be frustrating and uncomfortable.
Yes, I could simply get up anyway, but in my experience that tends to make the stay even more unpleasant.
So when I say I’m motivated to avoid another hospitalization, I mean it.
That fear has definitely influenced the way I eat and drink.
The strange side effect is that my diabetes numbers have been better because I’m controlling my portions and carbohydrates so carefully.
That doesn’t mean fear is a good dietary strategy.
It means I still have work to do finding a healthier balance.
CHF, CKD and Diabetes Don’t Always Play Nicely Together
This is where things get complicated.
With chronic kidney disease, nutrition may involve paying attention to sodium, potassium, phosphorus, protein and sometimes fluids depending on kidney function and lab results. The National Kidney Foundation stresses that these needs vary from person to person and should be individualized.
Then heart failure enters the picture.
My heart-failure plan includes careful sodium and fluid management.
Then diabetes adds another layer.
Carbohydrates matter because they affect blood glucose, and portion size matters even when the food itself seems “healthy.” The American Diabetes Association specifically emphasizes being mindful of carbohydrate intake and portioning carbohydrate foods appropriately.
That means I can’t simply look at something and ask:
“Is it low sodium?”
I also have to ask:
How many carbohydrates are in it?
How much potassium?
How much phosphorus?
How much fluid?
How large is the serving?
And how does it fit with everything else I’m eating that day?
The Rice Example
Rice is a perfect example.
Plain rice is naturally very low in sodium, which makes it attractive for a low-sodium diet.
But I’m starting to understand that the answer probably isn’t finding the perfect food.
It’s finding the right balance.
Low sodium doesn’t mean unlimited.
Neither does low carb.
Neither does low potassium.
Everything still has to fit into the bigger picture.
And for now, that’s a skill I’m still learning.
Medical Disclaimer: I am not a doctor or medical professional. The information on this page reflects my own personal experience living with chronic illness and managing my diet and health. What works for me may not be appropriate for someone else. Always talk with your doctor, dietitian, or other qualified healthcare professional before making changes to your diet, medications, fluid intake, or treatment plan.
This website is intended to share my journey, not to replace professional medical advice.
I woke up around 2:30 this morning. I’m still having trouble sleeping, but according to my Apple Watch, I managed 4 hours and 51 minutes.
Is that great? No.
But it’s better than no sleep, so I’ll take that win.
Something Different on the Scale
While doing my morning health checks, I noticed that my weight was up 1.1 pounds from yesterday.
That’s a little unusual for me, so naturally I started trying to figure out why.
My BIA scale actually showed my body-water percentage was about half a percent lower than yesterday. I’m also not noticing any swelling in my feet or legs.
Then I started going through the other possibilities.
The shirt I was wearing this morning was made from a heavier material than the one I wore yesterday. Could that account for some of the difference? Sure. But I seriously doubt my shirt weighs an extra pound.
I’m not constipated, so that probably isn’t contributing much either.
Then there’s dinner.
A couple of nights ago, we made those steak and shrimp rice bowls I mentioned in my last journal entry. They were so good that I ate more than I normally do. The shrimp we used also had some added sodium from processing.
Could the extra food, sodium and possibly a little fluid retention be contributing to what I’m seeing on the scale?
Maybe.
The truth is, I don’t know yet.
And that’s where I’ve learned not to overreact to a single number.
Watch the Trend
A 1.1-pound increase by itself isn’t setting off alarm bells for me. It’s simply something I’m going to pay attention to.
That’s one of the reasons I track this information every morning. One number gives me a snapshot. Several days of numbers give me a trend.
I’ll keep watching my weight, body-water reading, blood pressure and how I’m feeling over the next few days.
If the weight keeps climbing or I notice other changes, that’s information I can act on and share with my doctors.
For now, I’m monitoring it.
The last thing I want is another trip to the hospital.
Some Changes Around the Website
I also spent some time working on He’s Knocking on Your Door yesterday.
I’ve added featured content to the front page, so now you can see highlights from the Daily Journal, Living With It articles, and Helpful Finds without having to click around the site looking for something new.
I also decided to start adding featured images to these Daily Journal entries.
They were getting a little boring without something visual. Besides, some of the images are giving me an opportunity to have a little fun with what’s happening that day.
Yesterday’s Windex image might be difficult to top.
Otherwise, a Pretty Boring Day
Other than that, there isn’t a whole lot to report.
My hip still hurts—a lot.
One of the frustrating parts is simply trying to find a comfortable position. Sitting in a regular chair for any length of time can be difficult, which limits how much time I can spend working at a computer.
I can accomplish quite a bit from my phone or iPad, but there’s only so much I want to type or design on a smaller screen.
So today may be another relatively quiet day.
A little website work.
Keep an eye on the scale.
Deal with the hip.
And hopefully get a little more sleep tonight.
Not every day needs to be exciting. Sometimes a boring day is perfectly fine.
The Five Minutes Every Morning That Help Me Stay Ahead of My CHF
Living with congestive heart failure has taught me something important.
Your body is constantly giving you information.
The question is whether you’re paying attention.
Every morning, before I drink my morning water or begin my day, I spend about five minutes checking in with my body.
To some people, it probably looks like I’m filling out a simple spreadsheet.
To me, it’s much more than that.
It’s an early warning system.
Over time, I’ve learned that it’s much easier to recognize a problem before it becomes serious than it is to recover after the problem has already happened.
That’s why I track my health every single morning.
Not because my doctors told me to.
Because it helps me understand my own body.
One of the most important lessons I’ve learned while living with chronic illness is this:
Nobody will ever know your body as well as you do.
The more information I collect, the better conversations I have with my doctors, and the more confident I feel when something doesn’t seem right.
Download My Daily Health Tracker
If you’d like to use the same spreadsheet I use every morning, I’ve made an example version available for you to download.
Feel free to customize it for your own health conditions. What I track may not be exactly what you need, but hopefully it gives you a good starting point for building your own daily routine.
What I Track Every Morning
Below is a screenshot of the actual spreadsheet I use every day.
It isn’t complicated.
In fact, that’s intentional.
The easier something is to use, the more likely you’ll continue using it.
Each column serves a purpose, and together they give me a quick snapshot of how my body is doing each morning.
📅 Date
The first column simply records the date.
It sounds obvious, but dates become incredibly important when you’re looking for trends over several days, weeks, or even months.
Sometimes a doctor will ask,
“When did this start?”
Instead of guessing, I simply look back at my spreadsheet.
🕒 Time
I try to record my information at approximately the same time every morning.
For me, that’s usually around 5:00 AM, after using the restroom but before eating breakfast.
Keeping everything consistent makes it easier to compare one day to the next.
⚖️ Weight
Weight is probably the most important number I track.
For someone living with congestive heart failure, sudden weight gain often isn’t body fat.
It’s fluid.
That’s why I weigh myself every morning under the same conditions. After using the washroom and wearing the same type of clothes.
A sudden increase can be one of the earliest signs that my body is retaining fluid.
📈 Daily Weight Change
The next column calculates the difference between today’s weight and yesterday’s.
I’m watching for one thing in particular.
Have I gained 2–3 pounds overnight or about 5 pounds in a week?
Those numbers can be an early warning sign of fluid retention and may indicate that it’s time to contact my healthcare provider.
Instead of trying to remember yesterday’s weight, Excel does the math for me automatically.
💧 Water Percentage
My scale also estimates my body water percentage.
While I know this isn’t a perfect medical measurement, I still find it useful.
The spreadsheet uses that percentage to estimate approximately how many pounds of my body weight are water.
For something that only takes about five minutes each morning…
I’d say that’s time well spent.
⚠️ A Note About Pacemakers, ICDs, and Implantable Devices
If you have a pacemaker, ICD (implantable cardioverter-defibrillator), CRT device, or other implanted cardiac device, some consumer smart scales that measure body composition use a small electrical current (bioelectrical impedance analysis, or BIA) to estimate body fat, muscle mass, and body water.
Before using these features, follow the manufacturer’s safety instructions for your specific scale and ask your cardiologist or electrophysiologist if they’re appropriate for you.
If your healthcare team recommends avoiding these measurements, you can still use this tracker by recording your weight and the other health information without using the body composition features.
Medical Disclaimer
This spreadsheet is intended as a personal tracking tool only. It should never replace the advice of your healthcare providers or be used to make medication changes without their guidance.
The information in this article reflects my personal experience living with chronic illnesses, including congestive heart failure, atrial fibrillation, chronic kidney disease, and diabetes. It is shared for educational purposes only and is not medical advice.
Always follow the recommendations of your own healthcare providers regarding medications, diet, fluid restrictions, and health monitoring. If you notice sudden weight gain, worsening shortness of breath, chest pain, fainting, or any other concerning symptoms, contact your healthcare provider or seek emergency medical care as appropriate.
