Wednesday, January 26, 2011

Perk Test

One of the exciting perks of having diabetes is getting to give blood (for science) once a year.  I think I told you about her blood sugar being low, and crying while they took blood at her last endocrinology appointment here.  One of the reasons we do this is to check her health, to see if she's developing anything else (kids with auto-immune disorders often develop other problems along the way) and to see if her body is being well taken care of-diabetes is extremely hard on your blood vessels, kidneys, heart, nerves, and eyes.

We got Mary Claire's lab work results in the mail today.  I was quite alarmed as two of her values were over twice the upper normal range.  Her urine creatinine was 178.7 (normal range is 11-26) and her alkaline phosphatase was 272 (normal range is  50-136).  I read through all the other numbers, and at the bottom of the report, it gave a contact name and number.  I called the lady, and she said she didn't know what those two were, but they were usually raised in kids with diabetes.  (..and why is she the contact person?)  I emailed Mary Claire's doctor, and while I was waiting..

I googled Urine Creatinine, and found all sorts of things.  Here is the first: "I suppose that the most common reasons for developing raised creatinine levels will be when the filtration mechanism becomes gradually damaged by long-term raised blood pressure or diabetes.  (damaged?)  So, at least I know it really is in relation to Type I Diabetes (so I should turn off the alarm bells?)  It continues, "But, in very general terms, a rising level of creatinine signifies an increasing problem with poorly performing kidneys."  (Umm..can I get alarmed now?)  
We are always told what the issues and complications will be, but we concentrate so hard on managing and controlling the numbers everyday, that we can easily lose sight of the long-term.  I was under the (wrong) assumption (I know, it always makes an ass out of u and me-I must have heard it a thousand times-I can't even say the word without thinking about it!) that if we kept the numbers in range (70-125) that the complications would be majorly reduced.  Was I wrong?  (do we go back for a refresher course?)

Second, I googled Alkaline Phosphatase.  I had to know what it was too.  "Alkaline phosphatase is an enzyme widely found in the body, but is most concentrated in the liver, bone, kidneys, intestines, and the placenta in pregnant women." (from here)  "If a high level of alkaline phosphatase is found, further lab studies are needed to see if the elevated levels are coming from the liver or from bone."  So, then I was worried that she had a blockage in her liver bile ducts or breakdown of bone. (thanks to them)  Googling can make things worse.

I got a response (after googling), and he said that alkaline phosphatase is an enzyme associated with bone growth, and it'll be elevated in her until she stops growing. (Aha-and maybe it's also because her body is repairing that broken humerus?  maybe?  huh?  throw me a bone!)
He also says the urine creatinine is not a problem.  It can be extremely variable through the day.  The two most important tests for her kidneys are her serum creatinine and urine microalbumin to creatinine ratio which were both normal.  I'm going to trust him and not worry.  We'll test again next year, and if they are both still crazy high, then I'll freak out more.  For now, I will not worry.  She is a beautiful little girl full of hope and promise.  and she looks healthy.

Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance.  James 1:2-3

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