Bone pain rears its head again

For the last few weeks, I have been having bone pain again. I had severe bone pain towards the end of 2009. At that time I had realized that it was due to multiple factors - the low Calcium level in my dialysate and the low levels of Vitamin D in my body.

The problem with things that develop gradually in the body is that you are not sure until it becomes bad. For the last few weeks, I had pain on and off but I did not do anything about it. I was always wondering if it really was serious or was it just a passing phase? For example, joint pains can happen once in a while without indicating anything important, right?

But for the last few days, the signs were unmistakable. The only difference from last time was the areas in which the pain was there. While last time, it started mainly in the feet and back, this time, it is in the shoulders and back. It is quite bad in the morning. In fact so bad that I invariably get up at around 4 - 4:30 with the pain!

A few days back, I concluded that something was definitely wrong and got a battery of tests done including those for 25 hydroxy Vitamin D3 and 1,25 dihydroxy Vitamin D3 apart from Calcium and PTH. Both the Vitamin D3 results came back low. Especially the 1,25 test was shockingly low. The report says it was less than 1.6 pg/ml whereas the normal is 19.6 to 54.3! They don't even give a value. Just less than 1.6, they say. So it could practically be 0!

I went over to my nephrologist yesterday and he put me on Calcitriol 0.5 mcg once daily. Hopefully, this should correct my problem.


Anonymous said…
this is where the monk needs to sell his Ferrari.. take a step back and think of what could have been done differently. Here is what I don't understand about diabetes and dialysis in general. One of the main reasons for the various complications caused due to dialysis is definitely the fact that in most rural cases, diabetes is identified at a very late stage. But once identified, the next battery of tests really happens when the patient exhibits some symptoms. Same with dialysis. Now they say here in the US that everyone past 40 yrs needs to get checked for diabetes at least once every 5 years. but why stop there?(We know for a fact that diabetes and dialysis could have different side-effects in different folks and so I'll use them interchangeably) why cannot a pharma guy come up with a simple excel spreadsheet that lists all possible deficiencies (vitamins/ minerals/ elements - you name it) a diabetic could have and a 3-stage severity for the patient (say Red, Yellow and Green colors)? in your case for example, at some point, this spreadsheet would show that your grade for Vitamin D is a yellow which means you have a higher risk for this deficiency and so need to monitor it more often - say once every 6 months. If the rest are green, then they'll be monitored once every year and if it is a red, then its monitored once every month perhaps.. Take it to the next level at Nephroplus by devising a software that automatically reminds a patient when he checks in that he is due for this battery of tests based on his requirement..

again, its 12:58 AM here and so i could be rambling at times :)

good luck with your vit D