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By: Kayla Holmes  Beginning the process of seeing a specialist and establishing care can be daunting. We are here to help and make the process as smooth as possible.
I’m concerned about my kidney function. How soon can I be seen? Our goal is to see New Patients within 1-2 weeks of receiving an appointment request. However, this is not always possible. We keep an up-to-date callback list in order to move appointments within our goal time frame. Do I need a referral? Formal referrals are not required for some insurances and policies. We use the term to encompass the process of establishing communication with another provider or office and the documentation that is most helpful to facilitate a productive appointment. Formal referrals with referral authorizations are only required in certain circumstances based on the individual Insurance policy. If you are unsure if a referral is required, please contact your insurance carrier for more information. What documents are needed for my first appointment? The information needed to facilitate the most productive appointment includes, but is not limited to:
How do I get the necessary documents to your office? Obtaining lab results and other information pertinent to the appointment is preferred to make your appointment run smoothly and efficiently. There are a few ways to go about sending information over:
We will work with you every step of the way to ensure that you are prepared for your appointment and can be seen in a timely manner. If you have any questions or concerns regarding the referral process or how to see Dr. Munjal, please feel free to reach out to our office. By: Kayla Holmes  We’ve touched on what fluids are, how much too much can be, so it’s only right that we touch on dehydration to round out this segment of the Kidney Korner. Dehydration is simply when the body doesn’t have enough fluids to complete normal functions or when fluid intake is less than fluids lost. With summer in full swing, it is important to know the signs and symptoms of dehydration and how to treat it. Let’s discuss what causes dehydration, what symptoms to watch out for, and what to do if you become dehydrated.
What does dehydration have to do with my kidneys? Your kidneys control the fluid balance in your body. When you become dehydrated, your kidneys will have to work harder to try to maintain a fluid balance as well as perform their other functions. Dehydration can lead to increased blood pressure, a potential Acute Kidney Injury (AKI), or the worsening of Chronic Kidney Disease (CKD). What causes dehydration?
How do I know if I’m dehydrated?
What do I do if I’m dehydrated?
Munjal’s Musings: Dehydration occurs when the amount of fluids taken in is less than the fluids lost. Let's say you drink a gallon of fluids a day. Keeping that in mind, look at the two following scenarios:
Dehydration can be very dangerous if left untreated. This summer, remain mindful of the causes and symptoms of dehydration and learn to treat them immediately. Remember, hydration is a very delicate balancing act, so be sure to consult with a physician regarding your specific needs. What works for some, will not work for others. Tailor your needs accordingly and, as always, stay safe and healthy! *If you are on a fluid restricted diet, consult with your doctor and discuss these scenarios. To read our previous Kidney Korner posts on fluids, see the links below! Kidney Korner: Fluid Intake- Part 1 Kidney Korner: Fluid Intake- Part 2 By: Kayla Holmes  Habits and goals work together to become a dynamic duo when working towards accomplishing a task. Set a goal, then create habits to help facilitate the desired outcome. Let’s discuss the benefits of setting goals and creating habits.
Goals and habits can be particularly helpful for those with chronic illnesses that may need more in-depth and consistent healthcare. By creating healthy habits, like taking weight and blood pressure readings regularly, patients are able to better assist their healthcare teams in identifying trends and intervening more effectively and efficiently. This can help to increase time between required or recommended appointments as well as reduce emergency interventions, like hospitalizations. We have created a habit tracker for tracking weight and blood pressure that can be found on our website here. There are also a number of books and resources that delve deeper into the importance of habits and goals. If you are setting goals that may alter your lifestyle or health significantly, please consult with your physician(s) before continuing to ensure it is safe. As always, stay healthy!  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. Christopher, one of our fabulous Front Desk Coordinators, is our second quarter Teammate of the Quarter for 2023. We had the opportunity to sit down and learn more about what makes him an outstanding employee.
What is your schooling, background, and experience? I graduated from UNF this year with a bachelor degree in healthcare administration, and am BLS & CPR certified. I come from a long line of healthcare professionals in my family, and I can’t seem to break the curse! This is my first job in the healthcare field, and I want to demonstrate how much I care for my community through this wonderful opportunity. What are your hobbies and interests outside of work? I enjoy going to concerts, and indulging in my vast music collection. Going on walks and practicing my photography skills with my partner on some nearby nature trails has been a truly therapeutic pastime for me recently! What got you interested in healthcare? My father was certainly the biggest influence on my interest in healthcare; his profound love of caring for his own patients provided me a unique perspective where I could both philosophize on the importance of human life with him, as well as study his textbooks on the awesome complexities of our anatomy in my free time as a kid. He seemed to have the answer to every question I had. I have him to thank for pushing me in this direction. What are your passions? What drives and motivates you? All I ever wanted was to love and care for as many people as possible. Through my tribulations, I’ve garnered a sincere appreciation for what we’re all capable of, and I want to do my part in contributing to our time together on Earth. My motivation stems from the kindness and generosity of my partner Darren, who never gives up on me – to him, I owe so much. Do you have any special certifications or achievements? If so, what are they? Before I started college, I would frequently train students of all ages the martial art of Brazilian Jiu-Jitsu, which I studied for about half a decade. I became a NAGA champion twice, and have carried on these skills and taught others basic self-defense ever since. I can also finally tie a tie by myself after 23 years. Do you have any other fun facts about yourself you’d like your team and our patients to know? I sometimes make music online with my friend in South America! He’s a one-man band that invites me to perform vocals over his instrumentals. If you want to talk about music, I’m all ears! What do you enjoy most about being part of the team? I absolutely adore the level of respect we have for each other. We work incredibly well as a unit, and we all share the same passion for our patients and community. I was welcomed so quickly and seamlessly – it feels like this is somewhere I belong! Personally, my team is part of my family. I love knowing that I can rely on each of them for any and everything, and vice versa. Way to grow, Chris! Thank you for your hard work, passion, and hunger for knowledge.  Urology vs. NephrologyBy: Kayla Holmes
Nephrology and Urology work hand in hand to treat the kidneys and urological system. There is often overlap in what organs and systems are involved in these specialities. So what’s the difference? How do I know which I need to see? Read below to learn more about how these two specialties come together to create a dynamic duo for kidney health. Urology According to the Urological Care Foundation, “Urology is a part of health care that deals with diseases of the male and female urinary tract (kidneys, ureters, bladder, and urethra). It also deals with the male [reproductive] organs... Since health problems in these body parts can happen to everyone, urologic health is important.” Common conditions that urologists treat are:
Nephrology Nephrology is a branch of medicine that treats the kidneys. This can include the treatment of kidney diseases, monitoring kidney function, maintaining kidney health, and beginning renal replacement therapies. Common conditions that nephrologists treat are:
How do they work together? Urology and nephrology each treat different sides of the same coin. Kidney stones are a great example of how these two specialties work together. Nephrology will treat the prevention of stones through assessing lab work and imaging studies and suggesting changes to the diet or medication regimen. Urology will perform the necessary procedures to remove the stones if/when they become an issue. Who do I need to see? If you are experiencing frequent urinary tract infections, kidney stones, kidney cysts, or other conditions that involve the urinary and renal systems, urology is usually your best option. However, if you feel you need to see a nephrologist and are concerned about your kidney function, we are more than happy to see you and evaluate your needs. Munjal’s Musings: Urologists are the surgeons who deal with the hardware, removing the bad parts and making repairs. Nephrologists are medical doctors that will handle the software, making sure the kidneys are filtering and functioning properly. Resources: https://www.urologyhealth.org/urology-a-z/what-is-urology By: Kayla Holmes   Kidney stones can be a frightening diagnosis to hear. These are often regarded as painful, uncomfortable, irritating, and scary. The possibility of passing it naturally or going through surgery can cause a great deal of stress. Let’s discuss what kidney stones are, the signs to look for, and how we can help you get the care you need.
What are kidney stones? According to the Mayo Clinic, “kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys.” Kidney stones can be caused by a wide range of things like medications and supplements, diet, certain chronic illnesses, and body weight. How can I tell if I have a kidney stone? Some kidney stones can be passed without the patient even knowing. However, when there is a stone too large to pass or a significant build up of salts and minerals, there may be signs that you need to see a specialist.
Who do I need to see and what are my next steps? You will want to call a urologist as soon as possible. There are various labs or imaging that can be ordered. If the pain and discomfort is too intense, visit your closest emergency room or urgent care for evaluation. After seeing urology, they may refer you to a nephrologist to discuss the cause and prevention methods. If you suspect you may have a kidney stone, seek medical help as soon as possible. Nephrologists and urologists are here to help find the cause and treat the symptoms. As always, stay safe and healthy. Resources: https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755 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.  How Much is Too Much?In our last segment of the Kidney Korner, we discussed what fluids are and foods that have high water content, or insensible fluids (read about it here). This month, we are discussing hydration and how much fluid is too much for the kidneys to handle.
If you drink too much fluid, your kidneys may not be able to process and filter it properly (especially if you have kidney diseases) causing a myriad of problems. Decreased kidney function, Congestive Heart Failure (CHF), edema, liver diseases, and muscular issues have been linked to fluid retention. It is extremely important to maintain the balance of fluids and electrolytes in your body to stay healthy. Symptoms of overhydration can include swelling, increased trips to the bathroom (see the exceptions below), and clear, colorless urine (looks like water). There are many exceptions and special circumstances to consider when it comes to fluid intake.
Munjal’s Musings: How often do you water your plants? It can be complicated. You have to ask a few questions:
The same goes for people. Size, health status, medications, occupation, location, and the season are just a few of the elements that go into determining proper fluid intake for a person. You can also view hydration like filling a bucket. You want the bucket to be nicely topped off, not overflowing or only half full. It is a balancing act. It is important to have routine lab work done regularly and discuss your individual needs with your doctor(s). There is no universal guideline for the amount of fluids a person should consume daily. Tune in next week as we continue our segment on fluids and discuss the symptoms of dehydration and when to seek help. 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.  When a patient gets diagnosed with Chronic Kidney Disease, a lot of questions about diet and fluid intake tend to come up. How much should I drink? What should I eat? What needs to be taken out or altered in my normal diet? These can be daunting and seem overwhelming. An easy switch can be to reduce the added salt, or sodium chloride, when cooking. Added salt can come from your table salt shaker or other seasoning mixes commonly found in your spice cabinets. Added sodium can also come in the form of preservatives in canned goods, frozen foods, and boxed meals or ingredients. For more information on sodium, you can review our Kidney Korner segment on sodium here.
Common Seasonings with Added Salt
Seasonings as Salt Replacements
Be sure to check the labels of your spice bottles in all circumstances to ensure that it is truly free of sodium. When they have phrases like “No Salt Added,” “Salt Free,” and “Low Sodium,” it can mean that the salt has been replaced with potassium chloride, a different version of salt. This can be just as problematic as sodium chloride for patients with kidney diseases and hypertension. You can learn more about how to cook and season your food with spices instead of salt from the National Kidney Foundation here. If you have any questions or concerns about salt and sodium in your diet, you can contact your care team for additional assistance. As always, stay safe and healthy! Resources: https://www.nhlbi.nih.gov/health/educational/healthdisp/pdf/tipsheets/Use-Herbs-and-Spices-Instead-of-Salt.pdf  Hurricane season (June 1- November 30, 2023) is upon us. It’s important to be prepared if or when disaster strikes. More information and advice for preparing for hurricane season can be found here:
https://www.floridadisaster.org/planprepare/preparing-for-hurricane-season/ https://www.ready.gov/ https://www.cdc.gov/disasters/hurricanes/index.html Tax Free: May 27- June 09, 2023 August 26- September 08, 2023 https://floridarevenue.com/taxes/tips/Documents/TIP_23A01-02.pdf In addition to basic food and household supplies, it is important to have an emergency supply of prescription medications. We recommend that there is at least 2 to 3 weeks worth of medications on hand in an emergency preparedness kit. A great way to store these are with pill bags or resealable plastic bags. The prescription name, dosage, frequency, and expiration date can be written on the front of the bag for ease of identification. Please contact your pharmacy for timely refills of your medications. For those who may want or need to evacuate or do not feel comfortable traveling to our office, we will be continuing to offer virtual visits. Virtual visit coverage for Medicare patients has been extended to December 31, 2024. For commercial insurance, please contact your insurance carrier to inquire about virtual visit coverage under your plan’s contract. This is subject to change as more information is released. As always, stay safe and healthy! References: Florida Dept. of Revenue - Home. Florida Department of Revenue. (n.d.). Retrieved June 6, 2022, from https://floridarevenue.com/DisasterPrep/Pages/default.aspx Home. FloridaDisaster.org. (n.d.). Retrieved June 6, 2022, from https://www.floridadisaster.org/ https://www.flsenate.gov/Media/PressRelease/Show/4446#:~:text=The%20legislation%20creates%20a%2014,2023%2C%20for%20disaster%20preparedness%20supplies.  Urine can tell us a lot about your health, like hydration levels and kidney function. It is important to monitor your output to catch any significant changes, especially if you have pre-existing conditions known to potentially affect your kidneys and urine.
Appearance, Smell, and More: Foamy= Proteinuria, due to differences in the surface tension Red= Hematuria, blood in the urine, can indicate kidney stones, urinary tract infections (UTI), or other conditions Cloudy= Change in pH to alkaline indicating a number of potential causes like diabetes, infection, kidney disease or stones, vaginal discharge, or dehydration Dark= Dehydration Clear/no color= Over-hydrated Frequent urination= Urinary tract infection (UTI), overhydration, presence of waste in urine like sugars or protein Odd smell= Diabetes, urinary tract infection (UTI), dehydration, metabolic disorders Pain with urination= Kidney stones, urinary tract infection (UTI) Urine Tests: Lab tests can be ordered to examine the urine and begin to determine or monitor symptoms. These tests can include: Protein Total, 24-hour collections, Urinalysis with Culture, and more. Urine tests can monitor the levels of protein, bacteria, red/white blood cells, glucose, crystals, and hormones. According to Dr. Munjal, your urine should look like lemonade. This color comes from the waste the kidneys filter out. The concentration, or intensity of the color, is based on the water content of the urine. If you have any concerns about your urine or kidney function, speak with your care team for further evaluation. 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. Resources: https://my.clevelandclinic.org/health/symptoms/21894-cloudy-urine https://www.mayoclinic.org/symptoms/urine-odor/basics/causes/sym-20050704 |
