The Team Tibbs Results are in...

[jstuartrobson]

Is the general advice these days to use a tagaderm when showing? This was something that I couldn't get on with. My unit told me that I didn't need to use anything so I showered without any water proof dressings.

The caveat was to ensure the open wound was bone dry before putting the mepore on etc.

[Tibbs]

Is the general advice these days to use a tagaderm when showing? This was something that I couldn't get on with. My unit told me that I didn't need to use anything so I showered without any water proof dressings.

The caveat was to ensure the open wound was bone dry before putting the mepore on etc.

Was this for a PD tube?

The advice I had was to cover any site where there was an appliance that crossed the skin barrier, in my case a tesio line, and in this case a PD tube. It's not about the wound site being infected, it's about an infection travelling up the tube into your body.

[jstuartrobson]

Yep. I used to shower and wash the area with hibiscrub without any covering. I was told, as long as the water was flowing down the pd tube. Eventually they told me I didn't need to use hibiscrub and use normal shower gel. After showering, makesure the site was completely dry, then apply dressings.

It worked for me. No infections or anything.

[MandyV]

Each unit seems to give different advice - I have heard other units agreed showering was fine without a dressing. However our unit was clear that they required us to use tegaderm when getting wet. That may be on the conservative side but I would imagine that swimming - especially in public and bathing would be best done with dressings. Also depends on your exit site - I pretty much constantly had a scab ( nearly 6 years) but no infections at all - so a bit different if your exit site has healed completely ....

[Tibbs]

On a random note - with Hammersmith putting in a new Computer system, I asked if we were finally getting Renal Patient View.

Sadly not, as apparently RPV would cost £500k a year to run at HH...

[rheaybou]

right, I thought my sister had a recipe for the 'lasagne' but it turns out she made it up herself!

This is her recipe from memory

Right. This is a bit cobbled together as I sort of made it up as I went along! Cooking times etc are a bit approximate as I can't remember how long I cooked stuff for! It's lower potassium and pretty low salt etc although obviously each kidney patient has their own dietary requirements. Still. It didn't kill you, so....!!

Serves roughly 4. If I recall I dished it up with garlic bread on the side and a salad of iceberg and cucumber!!

"Bolognese"

400g meat. I used 200g extra lean minced beef and 200g turkey mince.

1 clove garlic

1 medium red onion peeled and cut in half (root on)

2-3 red peppers de-seeded and cut into quarters

2 tablespoons of cooking oil (I used sunflower)

Method

1. Heat oven (180 degrees).

2. Take half the red onion and cut into three through the root

3. Toss with the chopped red peppers and 1 tablespoon of oil and put in a roasting tray in the oven for about 30 minutes or until soft and browned (but not black!)

4. Meanwhile, finely chop the remaining half of red onion and crush the garlic clove.

5. Heat remaining 1 tbspn oil in a sided frying pan or saucepan. Sautee the onion and garlic for a couple of minutes and then add both types of mince and fry until browned. Drain carefully to remove all fat/liquid and set aside.

6. When onion/pepper in oven are soft, remove from oven. I can't remember if I removed the skin from the pepper or not. Sorry. Rinse in cold water and pat try and then blend with a stick blender or in a food processor to make the "sauce"

7. Return meat to frying pan/saucepan and put over heat. When it starts to sizzle add the sauce and stir to combine. I think I made it "saucier" by adding a splash or two of water - just do it by eye til the consistency looks right!


White Sauce:

1 oz plain white flour

1 1/2 oz non-dairy spread - I used Vitalite

10 fl oz rice milk. Take care to ensure it does not contain tricalcium phosphate

3 tablespoons of soured cream.

1. Put the flour, spread and rice milk into a saucepan and heat slowly whisking regularly until simmering and thickened. Simmer for a few minutes to cook out the flour and then remove from the heat.

2. Beat in the soured cream (you could also use cream cheese instead I think)


When I made up the "lasagne" I did it as follows:

Layer 1: "bolognese"

Layer 2: Thin layer of white sauce

I then added maybe a desert spoon of grated cheese - tiny amount but it makes a difference. Stronger the better to get flavour without needing to use too much!

Layer 3: Lasagne sheets

I repeated this again and finished with a final layer of white sauce.

For the topping I whizzed up two slices of white bread in the food processor to make breadcrumbs and mixed those with a tablespoon of grated parmesan and spread that over the top.

Pop into the oven at 190 degrees for 40 minutes and voila! Tastes NOTHING like lasagne but it was OK I think and most importantly satisfied your loss of saucy foods and gravy!!

The red pepper sauce can be used as a pizza sauce too. Spices can be added to the "bolognese" to make chilli....

Hope that's helpful.

Let me know how you get on with it. It tasted really good.

I am going to make this tonight, love turkey mince as it is so lean.

Burgers with 75% breast and 25% thigh meat, thyme and thin diced red onion are also very good. I make burgers with some of the mix and little mini meatballs with the rest. The meatballs are great to freeze and can be poached in a tomato sauce pretty quickly after work while past or rice cooks(if you take them out to defrost in the morning)

[Tibbs]

Clinic yesterday was busy as usual. I got in at 8:20 and left about 10:20.

I also saw a Reg, which is good as it means that they're not worried so much about me again!

My BP is loads better: 140/90 just before tabs and 128/70 after taking my morning BP lot!

So the Amlodipine is staying and looks like it's doing good.

Weight is the same, which is ok as Ive not been doing anything much really, but hopefully I can get back on it next week now I feel better heart-wise.

[Tibbs]

Time to resuurect this thread!

Clinic today was great - due to my new, shorter commute, I was in the clinic at 8:10 and first in the queue! Also moving from O2 to EE also means I can reliably get internet in the clinic which makes the waiting irrelevant. As it was, I was out by 9:30 having been told I didn't need to come back for 8 weeks!

Also checked that it was ok to try out the 'Slow Carb Diet' http://en.wikipedia.org/wiki/Slow-Carb_Diet as I tried the 5+2 and the 2 days fasting was not going to happen for me.

We'll see how it goes - I need to lose a lot of weight, and having seen the results from a chap at work, this combined with exercise will hopefully do the trick!

I'm also at the Bridges Walk this Sunday with the family. Is anyone else going?

[sanela]

Hi Tibbs,

Great clinic indeed today. You know things are going great when the time between appointments gets longer.

I've done the 5:2 and found it really easy, still on it though as I have a little way to go yet. Intrigued by the slow carb diet though.

Good luck on Sunday, hope the weather is good for it.


Sanela

[Dixie1]

Good news on the 'no clinic for 8 weeks' Tibbs.

Good luck on that diet! I would fail miserably as I love dairy, starches AND have a sweet tooth!! I find the only thing that works for me is using the 'myfitnesspal' app on my phone or pc, which involves plain old calorie counting. Basically allowed around 1200-1500 cals a day, depending on how much exercise (walking dogs) I have done, but at least I can eat/choose what I want. I always cheat at the weekends eg basically I don't bother counting lol as I only really have about 5kg (10lbs) to lose. The trouble is my weekends have started earlier and earlier. It used to be I'd cheat from Sat morn, then it was Friday night onwards and now, recently, Thursday night has become the new Friday........ Also I try not to drink any alcohol on weekdays.....

How are you finding the 5:2 Sanela? How much have you lost? Interested, but I just don't think I could get through the 'famine days'!

Good luck with the Bridges Walk Tibbs!

[wagolynn]

The latest research on sliming diets concludes, none of them work. The problem is none of them re-educate your brains (one in your head and the one that runs your digestive system). The rules are simple, if you think you are overweight - eat less or take some exercise.
The dietician tells me that slightly overweight patients cope with dialysis better...

[Tibbs]

The latest research on sliming diets concludes, none of them work. The problem is none of them re-educate your brains (one in your head and the one that runs your digestive system). The rules are simple, if you think you are overweight - eat less or take some exercise.
The dietician tells me that slightly overweight patients cope with dialysis better...

I was certainly told not to lose weight in the run up to transplant to keep me off dialysis - the more body mass, the better able you are to cope with all the crap floating around your system.

[sanela]

I was certainly told not to lose weight in the run up to transplant to keep me off dialysis - the more body mass, the better able you are to cope with all the crap floating around your system.

That actually makes sense to me and explains why nobody rushed me on to dialysis or ever told me to lose any weight, I had a lot of padding!

I get bored easily with any eating "regime" long term. Hence why 5:2 - the original, works for me. I already don't eat between 8pm and 11am the next day (weird shift hours, prograf times) so all I really do is drink plenty of fluids/clear broth/tea instead of food until 7pm, have a light meal and it's 8pm already after which I don't eat again. Total loss on this 6kg with mild exercise (could do better). Altogether lost since my transplant 14kg, around 8kg to go but I'm taking it really slow. The thing is, I really enjoy having some time "off" from food - this from a food lover, cook and baker...


Sanela

[Dixie1]

Wow, 6Kg, well done! This does sound quite intrigueing but not sure how I would do, as I am such a grazer.... The problem I am having nowadays is the nausea when I get hungry, especially when I first wake up. Feel crap until I have eaten... Did any of you guys have this, prior to transplant? Nausea caused by hunger/acid??

[Tibbs]

Yes, I definitely had it pre-transplant.

I was on so many Sodium Bicarbs for my Potassium that my stomach was very sensitive - eat too much and it was very uncomfortable.