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THE BEAN:
Kidney Empowerment

Book of the Quarter: Braving the Wilderness

3/9/2023

 
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Braving the Wilderness by Brene Brown is a book that explores the power of  independence, courage, and belonging. Brene uses the term “wilderness” as a metaphor to describe the elements we must face to find belonging: solitude, vulnerability, vast and dangerous environments, and the beauty of nature. You must find  your own way through the wild, straying from the beaten path, listening to yourself. It’s about intentionally putting yourself with those who are different from you in culture, beliefs, and ideologies and learning to be with others without sacrificing who we are. Brene uses the acronym BRAVING to help assess trusting others and yourself.

Boundaries: Asking for and respecting boundaries
Reliability: understanding competencies and limitations to do as you say
Accountability: owning mistakes, apologizing, and making amends
Vault: not sharing things that are not yours to share and upholding confidences
Integrity: choosing courage over comfort and what is right versus what is easy
Nonjudgement: speaking without judging or being judged
Generosity: extending the most generous interpretations of intentions, words, and
Actions

Brene goes on to discuss topics around boundaries. She explores how to embrace our own humanity to connect with others, practicing civility, and conflict management. She explains that changing perspective and working with the mind can be more beneficial than changing physical surroundings to make someone more at ease or comfortable. Life isn’t comfortable. Brene courageously shares her own vulnerable stories of connection, fear, and longing to help show that we are not alone, but we can certainly stand alone. 

How it helped us:   
Braving the Wilderness has helped our Patient Educator, Kayla, in her ability to grow as a professional. “I was able to connect with others on a more personal level. I was more courageous to admit mistakes and failures. We are all human. We are not alone in our mistakes, faults, and struggles. I felt like I was able to handle tough conversations and conflicts with ease and civility.”

How it can help our patients: 
Braving the Wilderness can help our patients realize that they are not alone in their chronic illness and the associated challenges. Gaining perspective on vulnerability and connection can greatly benefit patients and how they connect with their care teams and support people. 

How can you practice braving the wilderness in your daily life? 

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The Importance of Routine Care

3/9/2023

 
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Regular follow ups with primary care and other specialists are vital to maintaining overall health and wellness. Below are lists of vaccines, suggested screenings, and testing that is recommended on a regular and/or annual basis.

Vaccines:
  • Flu
  • COVID
  • Shingles (50+ years)
  • Pneumococcal Pneumonia (65+ years)
  • Td/Tdap- Td booster (tetanus and diphtheria)
  • MMR (Measles-Mumps-Rubella)- need at least one dose if born after 1957, certain adults may need 2
For additional information on vaccines: https://vaccinateyourfamily.org/adults/?gclid=Cj0KCQiA-JacBhC0ARIsAIxybyMJAUssac8FjugH_be4E_uzcN10M2LvJqypt2_EHcveq4Gju0eM3cIaAsIdEALw_wcB

Suggested Annual Screenings for Adults:
Most of this is taken care of by a Primary Care Physician (PCP). It is important to maintain a relationship with your established PCP to ensure timely care and referrals. In addition to the recommended annual physical, it is important to ask about the following:
  • Hearing Test
  • Blood Pressure Check
  • Eye Exam
  • Obesity management
  • HIV testing
  • Hepatitis C testing
  • Cancer screenings
  • Vaccinations
  • Bone Density (osteoporosis) testing
  • Cholesterol testing
  • Diabetes testing
  • Teeth Cleanings

Preventative Care Testing May Include:
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Complete Blood Count (CBC)
  • Hemoglobin A1C
  • Echocardiogram (ECG)
  • Pap Smear (women)
  • Prostate Specific Antigen (PSA)
  • Thyroid Stimulating Hormone (TSH)
  • Colonoscopy
  • Mammogram (women)
Everyone’s care looks different. If you are unsure who you may need to see, start with a primary care physician. They can assess and direct you where you may need further care. Don’t forget to schedule your appointment with your favorite nephrologist, Dr. Munjal! As always, stay safe and healthy.

​​This website is for informational and educational purposes ONLY. While we strive for accurate, general medical information, this does not replace professional medical advice. Do not rely solely on this information. Please consult with your physician for more information regarding your specific needs. If you are experiencing a medical emergency, please call 911.

Eating Healthy on a Budget

2/23/2023

 
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Eating healthy can seem like an impossible task nowadays. However, it may be easier than you think. Listed below are some tips to keep your health on track and your wallet happy. 

What is “healthy eating”?
Healthy eating can look different for everyone based on dietary needs and health conditions. The U.S. Department of Health and Human Services defines “eating healthy” as a “healthy eating pattern that includes a variety of nutritious foods and drinks. It also means getting the number of calories that’s right for you (not eating too much or too little).” It is especially important for patients with kidney diseases or on dialysis to consult with their healthcare providers and dieticians when considering changes in diet.

Tips:
  1. Buy frozen fruits and vegetables. Frozen fruits and vegetables are usually flash frozen after harvesting, so more nutrients are locked in. They are also often cheaper than fresh produce and may go on sale or have deals like Buy One/Get One (BOGO) free or half off.
  2. Buy fruits and vegetables that are in season. These are more easily accessible, therefore reducing their cost. If you need a guide to seasonal produce, you can find some here:
    1. Seasonal Food Guide
    2. FDACS: Crops in Season
  3. Use coupons! Most stores have weekly or monthly ads that include sales or coupons. Use this to plan your weekly meals.
  4. Make a weekly menu. By making a weekly menu, it is easier to buy only the items needed for meals. This can reduce the stress of deciding meals and impromptu trips to the grocery store.
  5. Shop with a list and stick to it. By sticking to a list based on the menu planned out, there is less of a chance of buying unnecessary items.
  6. Meal prep ahead of time. Having meals prepared ahead of time can make you less likely to eat out due to forgetting to set out items for dinner or getting to meals late.
  7. Buy items that can be used in multiple dishes. Buying specialty items for specific recipes can lead to food waste.
  8. Buy store brands. Store brands often offer the same or similar items at a lower cost. 
  9. Shop at wholesale stores like Costco, Bj’s, or Sam’s Club. Buying in bulk can reduce the price and last longer, thus extending your trips to the grocery store.

For more information on healthy eating, we have provided some resources below. Please contact your healthcare provider(s) before changing your diet or health habits should you have any conditions that require dietary restrictions. 
Health.gov
World Health Organization
CDC

Eating healthy doesn’t have to be scary or a chore. Let us know what works best for you! As always, stay safe and healthy!

​

Kidney Korner: Electrolytes- Sodium

2/16/2023

 
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What is sodium?
Sodium is an electrolyte with a positive charge. This differs from salt (sodium chloride) in that salt is a chemical compound while sodium is an element. We will be discussing sodium.

What does sodium affect? 
  • Blood pressure- too much sodium can lead to high blood pressure
  • Fluid balance outside of the cells
  • Potassium levels

Common Sources of Sodium
  • Smoked, cured, salted, or canned meats (jerky, cold cuts, fish, poultry, bacon, sausages, etc.)
  • Canned foods (soups, beans, vegetables, etc.)
  • Boxed foods
  • Frozen meals
  • Breads and rolls
  • Cheese
  • Pizza
  • Pasta dishes

How Dr. Munjal Helps:
Dr. Munjal can make dietary change recommendations, order Basic or Comprehensive Metabolic Panels (BMP/CMP) to check electrolyte levels, or order various supplements or infusions. 

Munjal’s Musings:
Sodium can come from a variety of sources, salt being one of them. One of the other most common sources of sodium is food preservatives. While it may be tasteless and not “salty,” it does not mean that it does not have sodium. A low sodium diet is generally recommended for patients with high blood pressure and kidney diseases. 

If you have any concerns or questions regarding sodium, please contact your Primary Care Physician or Nephrologist for recommendations. As always, stay safe and healthy!


Resources
CDC: 10 Sources of Sodium
UCSF: Guidelines for a Low Sodium Diet

​This website is for informational and educational purposes ONLY. While we strive for accurate, general medical information, this does not replace professional medical advice. Do not rely solely on this information. Please consult with your physician for more information regarding your specific needs. If you are experiencing a medical emergency, please call 911.

Walk it Out: Ten Benefits of Walking for Overall Health

2/9/2023

 
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Walking is an underrated form of exercise that has a long list of useful benefits. Here are 10 benefits of walking that can improve your health.
  1. Improve balance and coordination. Walking can help to decrease your fall risk.
  2. Improve mood, memory, and cognition. Light aerobic exercise has been shown to increase the circulation to the brain and can influence parts of the brain to change reactions to stress, thus helping to reduce anxiety and depression.
  3. Decrease risk of chronic illnesses. These illnesses can include heart disease, stroke, and diabetes. 
  4. Strengthen bones and muscles. Regularly using your muscles, especially on a variety of terrain, will keep bones strong and muscles active.
  5. Increase energy levels. Walking increases the amount of oxygen in your blood and increases the levels of hormones in your body that are shown to increase energy.
  6. Manage weight. Walking is a light exercise that can help one lose fat and gain muscle to maintain a healthy weight.
  7. Increase cardiovascular fitness. Walking at least 30 minutes a day, for 5 days a week, can reduce your risk of coronary heart disease by 19%.
  8. Improve mental health. Anxiety and depression levels have been shown to decrease with a regular walking routine.
  9. Keep joints flexible. Walking can help protect the joints, including your knees and hips.  It helps lubricate and strengthen your muscles that support the joints.  Walking 5 to 6 miles a week may help prevent arthritis.
  10. Boost social life. Walking with a buddy or group will help to increase and improve one’s social life and create a deeper bond with others. 

Safe Walking Practices:
  1. Find a walking buddy. Having someone to walk with can increase your motivation to walk. Walking with another person is also beneficial to ensure that, should something happen, you are able to get assistance quickly. 
  2. Walk during daylight hours. Walking at night can decrease one’s awareness of their surroundings. 
  3. If walking outside, stay close to home or your vehicle. By maintaining a shorter distance to safety, it can reduce the risk of becoming stranded due to exhaustion.
  4. Bring water. It is important to stay hydrated when exercising to decrease the risk of dehydration. Consult with your physician should you have fluid restrictions. 
  5. Bring a phone. Cell phones are convenient for playing music, audiobooks, podcasts, or to contact someone should an emergency arise.
  6. Bring something to assist with walking. Canes, walkers, or walking sticks can help increase stability and decrease fall risks.
  7. Wear sunscreen and protective clothing to prevent sunburns.
  8. Wear sturdy, comfortable shoes. Proper, supportive shoes can reduce the risk of injury and assist with creating a proper gait. ​

Consult with your healthcare provider(s) before altering or increasing your exercise habits to ensure that walking is a safe exercise for you. As always, stay safe and healthy!

Resources:
Sharma A, Madaan V, Petty FD. Exercise for mental health. Prim Care Companion J Clin Psychiatry. 2006;8(2):106. doi: 10.4088/pcc.v08n0208a. PMID: 16862239; PMCID: PMC1470658.
https://www.healthline.com/health/benefits-of-walking#muscle-tone
https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/walking/art-20046261
https://www.betterhealth.vic.gov.au/health/healthyliving/Walking-the-benefits-for-older-people

​This website is for informational and educational purposes ONLY. While we strive for accurate, general medical information, this does not replace professional medical advice. Do not rely solely on this information. Please consult with your physician for more information regarding your specific needs. If you are experiencing a medical emergency, please call 911.

Demographics: What are They and Why are They Important?

1/26/2023

 
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Your demographic information is a vital part of your care. It is protected by HIPAA and therefore cannot be shared or altered without patient consent. 

What is considered demographic information?
  • Name
  • Date of Birth (DoB)
  • Address
  • Phone Number(s)
  • Email address(es)
  • Insurance information
  • Race
  • Ethnicity
  • Gender

Why is it important?
Demographic information is vital for medical billing, insurance, communications, and patient identification. Out-of-date demographic information can lead to:
  • Missed appointments due to failed reminder calls
  • Insurances being unable to pay for appointments
  • Missed statements and letters from our office that may contain sensitive information
  • Missed information or inability to leave voicemails regarding medical questions or updates from your physician

How you can update your information:
  • In-office with our annual chart review or new patient paperwork
  • Download the paperwork from our website to mail in or bring at your next appointment (https://www.jaxnephrology.com/patient-forms.html) 
  • Through the patient portal (view only on the Healow App) (https://mycw28.eclinicalweb.com/portal2741/jsp/100mp/login_otp.jsp)
  • Call our office at (904) 260-9898
​
We try to update this information on an annual basis. You can review our previous post on HIPAA (Be HIP(PA) and Know Your Rights) to learn how we protect your information. If you have questions, concerns, or any changes in the new year, please do not hesitate to call our office. 

2022 Quarter 4 KUDOS+ Employee of the Quarter: Samantha

1/20/2023

 
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We believe in recognizing and acknowledging the growth and hard work our team has shown. To do this, we began a program within the office we call KUDOS+. Our team is able to give praise and acknowledge exemplary work by their teammates throughout the quarter. At the end, the teammate with the most KUDOS+ given by their team is appointed the teammate of the quarter. Samantha, our Remote Patient Monitoring Care Coordinator is our fourth quarter teammate of the Quarter for 2022. We had the opportunity to sit down and learn more about what makes her an outstanding employee.


What is your schooling, background and experience?
  • I have an AA degree and I'm working toward my Bachelor’s degree in aviation maintenance. I spent the past 10 years in the Army as a helicopter mechanic serving all over the world.
What are your hobbies and interests outside of work?
  • I love spending time with my family, enjoying all aspects of food, and listening to podcasts about true crime. 
What got you interested in healthcare?
  • I love to help others. Being able to build relationships with people and help them through their health journey has been a pleasure.
What are your passions? What drives and motivates you?
  • I enjoy problem solving and brainstorm solutions.
Do you have any special certifications or achievements? If so, what are they?
  • I have various certifications from the Army that helped me develop my career there. I hope to continue my education in the future. 
Do you have any other fun facts about yourself you’d like your team and our patients to know?
  • I am full of a variety of “useless” information about a wide range of topics and a self-professed true crime expert and aficionado. 
What do you enjoy most about being part of the team?
  • The environment that Danae and Dr. Munjal have created fosters opportunities for growth, development, and fun each day. We are able to learn from our mistakes and train to help one another. ​

​We are so thankful to have Samantha on our team, empowering our patients every day. Way to grow, Sam! 

January 19th, 2023

1/19/2023

 
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Did you know that your electrolytes play a vital role in the regulation of blood pressure and fluid balance?

What are electrolytes?
Electrolytes are substances that hold a positive or negative charge and can thus conduct electricity when dissolved in water. Electrolytes (and their charges) found in the body are:
  • Sodium (+)
  • Magnesium (+)
  • Potassium (+)
  • Calcium (+)
  • Chloride (-)
  • Phosphate (-)
  • Bicarbonate (-)

What do electrolytes do?
Electrolytes assist in regulating the fluid balance in the body and muscle contraction through chemical reactions.

What can cause changes in electrolytes?
  • Sweating
  • Poor diet and hydration
  • Medications
  • Vomiting
  • Diarrhea
  • Chronic Kidney Disease (CKD)
  • Diabetes
  • Heart failure
  • Blood pH levels

How Dr. Munjal Helps:
Dr. Munjal can order a Basic or Comprehensive Metabolic Panel (BMP/CMP) to measure the electrolytes’ levels present in the blood. From there, more specified tests can be ordered to determine a precise cause or imbalance. Supplements, infusions, or dietary recommendations can be ordered. Follow-up appointments will be necessary to monitor progress and changes. 

Munjal’s Musings:
The electrolyte levels in your body are not necessarily a reflection of your nutrition or intake, but a measurement of their balance in your blood. In the next Kidney Korner installations, we will be going into more detail on sodium, potassium, and phosphorus. 

If you have any concerns about your electrolyte levels, contact your Primary Care provider or nephrologist. As always, stay safe and healthy! 

​Resources:
 

https://my.clevelandclinic.org/health/diagnostics/21790-electrolytes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369961/

This website is for informational and educational purposes ONLY. While we strive for accurate, general medical information, this does not replace professional medical advice. Do not rely solely on this information. Please consult with your physician for more information regarding your specific needs. If you are experiencing a medical emergency, please call 911.

​

New Year's Goal Ideas

1/12/2023

 
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“The best time to do something significant is between yesterday and tomorrow.” Zig Ziglar

With the start of the New Year comes the start of new personal and professional goals. We want to help you set and reach and exceed them. We have provided a list of goal ideas from all areas of life. We also have downloadable goal sheets on our website to help you kick-start your plans.

Health Goals
  • Weight management
  • Lower blood pressure
  • Eat a healthier diet (incorporate more whole foods, reduce sodium, monitor fluids, etc.)
  • Exercise more regularly (walks, yoga, water aerobics, etc.)
  • Quit smoking/drinking (attend support group meetings, consult physicians, go to therapy, etc.)
  • Cook more at home (try new recipes, bring our old family recipes, bake, etc.)
*Before making any significant health choices, consult your physician(s) to ensure your goals are safe for you.*

Personal Goals
  • Be more positive (write daily gratitude lists, go to therapy, speak more positively to yourself and others, meditate, etc.)
  • Spread more kindness through compliments or random acts of kindness
  • Pick up a new hobby (knitting/crocheting, scrapbooking, painting, etc.)
  • Save more money (open a new savings account, $5 challenge, reduce spending, etc.)
  • Travel more (plan a vacation, visit family, explore your local area, etc.)
  • Read more (try new genres!)
  • Spend more time with friends and family (organize a family reunion, schedule dates with friends, plan parties, etc.)
  • Get involved with and support the community (volunteer, go to religious/community events to learn about the culture in your area, eat at local restaurants, etc.)
  • Talk less, listen more

Professional Goals
  • Learn more skills at work
  • Cross-train in other positions
  • Find a new job in a different field
  • Go back to school to pursue a dream career
  • Become a better teammate or leader
  • Create more learning opportunities for staff (webinars, training events, book clubs, etc.)

Check out our previous post, New Years Preparations, to learn more about goal setting!

​

How to Help Your Loved Ones with Chronic Kidney Disease

12/29/2022

 
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Having a strong support system is crucial for anyone living with a chronic illness. Kidney disease is no different. It is complex and can be potentially life altering. We’ve compiled some tried and true ways to support a loved one who is living with Chronic Kidney Disease (CKD).

Learn about the kidneys and their disease.
  • Empower yourself  with knowledge about what they're going through, changes they may need to make, and the components and contributing factors. The more a support person knows, the better they understand and are able to help. 
Offer to help and participate in their care
  • Encourage your loved ones to remain consistent on their prescribed diets and medication. 
  • Offer to drive them to appointments and/or participate in appointments (with the patient’s consent)
  • Help them grocery shop and meal prep to avoid deviations from dietary restrictions
Engage by sharing information and resources with them.
  • National Kidney Foundation
  • Chronic kidney disease - Symptoms and causes - Mayo Clinic
  • FAQs – AAKP
  • Chronic Kidney Disease (CKD) | NIDDK
  • Chronic Kidney Disease Basics
  • The Jacksonville Nephrology Blog: The Bean: Kidney Empowerment
Consider becoming a living donor.
  • Did you know that you can live a healthy life with one kidney? Should your loved one’s kidney disease progress to needing dialysis or transplantation, consider becoming a living donor. While you may not be a perfect match, you could potentially save someone else’s life. 
Empower others by becoming an advocate.
  • There are various ways to become an advocate for those living with CKD. There are various community pages that bring together caretakers, support people, patients, health care professionals, and members of the community. There are also annual walks, social events, and fundraisers nation-wide to support the millions of people with CKD. Jacksonville Nephrology walks annually with the National Kidney Foundation to support our patients and community. 

The Jacksonville Nephrology Team is here to support you on your journey with CKD. Should you have any questions or concerns, feel free to reach out to our office.



Resources:
National Kidney Foundation
National Kidney Foundation
Renal Support Network​
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    About The Bean 

    The Bean is a blog on a mission to share valuable information in the world of Nephrology.  We believe in empowering through education and The Bean is a great place to find resources and information on topics related to high blood pressure, kidney disease, dialysis, and topics that enhance the kidney minded lifestyle.    Enjoy and be sure to subscribe!

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