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Sent: Sunday, September 29, 2002 11:38 PM

Subject: Blood markers indicate how well your kidneys function

Blood markers indicate how well your kidneys function

Bloodwork consistently shows that my "creatinine" level is high. Nurses and doctors advise me to drink more water, but lots of water has no effect. Any advice? What you're describing is one of several markers doctors use to figure out how well your kidneys are working.The serum BUN (blood urea nitrogen) level is another important blood level that goes hand in hand with a blood creatinine level. It would be helpful to know your BUN level, too.Blood urea nitrogen and creatinine are just breakdown products of blood and muscle, respectively. In a normal healthy state, there's a fairly steady and predictable breakdown of old red blood cells and muscle so that the amount of BUN and creatinine in the blood remains within a normal range.But if either too much blood or muscle breakdown occurs, or the kidneys can't properly get rid of these waste products, the blood levels of BUN and creatinine will rise.What's more, in a state of dehydration, the level of BUN rises much faster in proportion to the level of creatinine. An abnormally high BUN-to-creatinine ratio suggests dehydration.The problem with interpreting your rise in serum creatinine is that it could mean several different things. Yes, it could mean that you're dehydrated, but I don't have enough information to be sure.One very common cause for an unexplained recent rise in creatinine is a side effect from a medication. For example, if you're taking a water pill for blood pressure or fluid retention, that could dehydrate you a bit and make both the BUN and creatinine levels rise. I'd recommend that you review your medication list with your doctor to determine whether some drug is affecting your creatinine level.If no offending medication is found, I'd see a kidney specialist. A 24-hour urine collection can measure creatinine and protein excretion and determine extent of kidney impairment.Your problem may be acute and reversible, or it might be a chronic decline in kidney function from high blood pressure, diabetes, or kidney disease. Mild impairment isn't necessarily cause for concern, but it does need to be watched.Lastly, make sure your doctor isn't giving you any pills that can hurt your kidneys.Sneezes are violent, but heart doesn't stopIs it true that people say "God bless you" after someone sneezes because the heart stops beating? Fortunately, the heart doesn't stop when we sneeze. The sneeze reflex simply is an automatic response to irritation.The walls of the nasal cavity are irritated, conducting nerve impulses to the brain. The uvula (that odd flap hanging from your upper palate above the tongue) closes off the mouth area from the upper airway so that air is forcefully directed through the nose. But most adults sneeze through their mouth, not their nose.Looking at the sun can trigger the sneeze reflex too, through accidental stimulation of those same nasal nerve receptors. Light is supposed to activate only an eye reflex.A sneeze is a pretty violent expulsion, however. It momentarily decreases the flow of blood to the heart. Several hard sneezes may cause a momentary dip in blood pressure, causing a second or two of lightheadedness.Still, that's not the same as your heart stopping. (The heart may well skip a beat. The next time you sneeze, feel your pulse at the wrist and you'll see.)The origin of "God bless you" reportedly dates back 1,500 years to the time of a plague in Europe. Originally started as a congratulation to the sneezer for expelling evil from his body, it evolved into a law, passed by the pope, to bless the person against the plague. Today, we also say "gesundheit" - German for "good health."By the way, the earliest surviving copyrighted motion picture is of a sneeze. It was made in January 1894 by W.K.L. Dickson, an assistant in Edison's New Jersey laboratory.gigi* Catching us up on many things too :)* http://www.philly.com/mld/inquirer/living/health/4130768.htm

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