Part I What is Legionnaires?

Legionairres outbreak 

legionnaires how its picked up

The top illness of the month seems to be Legionnaires. Legionnaires’ disease is a severe form of pneumonia — lung inflammation usually caused by infection. Legionnaires’ disease is caused by a bacterium known as legionella.

You can’t catch Legionnaires’ disease from person-to-person contact. Instead, most people get Legionnaires’ disease from inhaling the bacteria. Older adults, smokers and people with weakened immune systems are particularly susceptible to Legionnaires’ disease.

The legionella bacterium also causes Pontiac fever, a milder illness resembling the flu. Separately or together, the two illnesses are sometimes called legionellosis. Pontiac fever usually clears on its own, but untreated Legionnaires’ disease can be fatal. Although prompt treatment with antibiotics usually cures Legionnaires’ disease, some people continue to experience problems after treatment.

Legionnaires’ disease usually develops two to 10 days after exposure to legionella bacteria. It frequently begins with the following signs and symptoms:

  • Headache
  • Muscle pain
  • Chills
  • Fever that may be 104 F (40 C) or higher
  • By the second or third day, you’ll develop other signs and symptoms that may include:
  • Cough, which may bring up mucus and sometimes blood
  • Shortness of breath
  • Chest pain
  • Gastrointestinal symptoms, such as nausea, vomiting and diarrhea
  • Confusion or other mental changesA mild form of Legionnaires’ disease — known as Pontiac fever — may produce signs and symptoms including fever, chills, headache and muscle aches. Pontiac fever doesn’t infect your lungs, and symptoms usually clear within two to five days.WHEN TO SEE A DOCTOR:
  • Remember this about Legionnaire’s disease:Although the disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

See your doctor if you think you’ve been exposed to legionella bacteria. Diagnosing and treating Legionnaires’ disease as soon as possible can help shorten the recovery period and prevent serious complications. For people at high risk, prompt treatment is critical.


Part II Acute Renal Failure versus Chronic Renal Failure


Chronic Renal (Kidney) Failure:

In giving a short and easily understandable definition Chronic kidney disease happens when your kidneys no longer filter your blood the way they should, so wastes (toxins, usually end products of an acid) build up in your blood. This has probably been going on for years, and it may keep getting worse over time. Just like a car engine damaged but still using the car without getting the engine repaired sooner or later in time the engine no longer functions the same with any organ of the body getting damaged by some long term condition. If your disease gets worse and worse over time, you could have kidney failure for some multi organ failure, depending on the condition causing this.*

The most common causes of Chronic Renal Failure are:

-Diabetes (uncontrolled diabetes (Type 1 or 2) for many years. *-High blood pressure for many years.                                   These are the top 2 causes of most chronic kidney disease. Controlling these diseases can help slow or stop the damage to the individual’s kidneys who has one of these, if not both.

Other causes that can lead to chronic kidney disease include:   -Kidney diseases and infections, such as polycystic kidney disease, pyelonephritis, and glomerulonephritis, or a kidney problem you were born with.

-A narrowed or blocked renal artery. A renal artery carries blood to the kidneys.

-Long-term use of medicines that can damage the kidneys. Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), such as celecoxib and ibuprofen.

Know this for starters, each of your kidneys has about a million tiny filters, called nephrons.The nephron is the tiny filtering structure in your kidneys. Each of your kidneys contain more than a million tiny filtering nephrons that help clean your blood removing toxins dumping them into your urinary bladder so you can evacuate them though urine (urea, urine; get it). Your nephrons play a vital role to our essential daily living. They help all humans do the following if there kidneys or one kidney is functioning properly. They:

  • -Remove excess water, wastes (like urea, ammonia, etc.) & other substances from your blood.
  • -Return substances like sodium, potassium or phosphorus whenever any of these substances run low in your body.
  • If nephrons are damaged by the high sugar content or high blood pressure in the kidneys, they stop working. For a while, healthy nephrons can take on the extra work or overload. But if the damage continues, more and more nephrons shut down. After a certain point, the nephrons that are left cannot filter your blood well enough to keep you’re blood filtered properly to keep you healthy. Just like running from a bear in the street chancing you. We can run only so long but sooner or later we will run out of energy and not be able to run anymore, same concept for the kidney nephrons when they run out of enough not properly working.-Urinate less than normal. *
  •  -Have swelling and weight gain from fluid buildup in your tissues. This is called edema.*
  • -Feel very tired or sleepy. *
  • -Not feel hungry, or you may lose weight without trying.*
  • -Often feel sick to your stomach (nauseated) or vomit.*
  • -Have trouble sleeping.*
  • -Have headaches or trouble thinking clearly.
  • Your doctor will do blood and urine tests to help find out how well your kidneys are working. These tests can show signs of kidney disease and anemia. (You can get anemia from having damaged kidneys.) You may have other tests to help rule out other problems that could cause your symptoms.
  • To diagnose chronic renal failure is pretty much the same tests that are listed above on acute renal failure plus:Chronic kidney disease is also called chronic renal failure or chronic renal insufficiency.There are five stages of kidney disease, from kidney damage with normal GFR to kidney failure.  So GFR will help the MD rule out acute versus chronic to give the MD direction on Rx.Your doctor will ask questions about any past kidney problems. He or she will also ask whether you have a family history of kidney disease and what medicines you take, both prescription and over-the-counter drugs. 
  • Treatment (Rx) for Chronic Kidney (Renal) Failure:There are things you can do to slow or stop the damage to your kidneys. Taking medicines and making some lifestyle changes can help you manage your disease, prevent further damage to the kidneys, if their functioning at all and make you possibly feel better.
  • Kidney disease is a complex problem. You will probably need to take a number of medicines and have many tests. To stay as healthy as possible, take your medicines just the way your doctor says to and work closely with your doctor. Go to all your appointments for the MD to see a increase in function or decrease in function of your kidney or kidneys you have still functioning to a level. To do that you can’t just go every 6 months especially when first diagnosed with it or with a collapse of an exacerbation of kidney failure in a worse level that brought on new symptoms that brought you to the ER. Lifestyle changes are an important part of your treatment. Taking these steps can help slow down kidney disease and reduce your symptoms. These steps may also help with high blood pressure, diabetes, and other problems that make kidney disease worse or made the kidney disease happen with the secondary diagnosis you had originally for years (ex. Hypertension or Diabetes if not both especially is uncontrolled).
  • Very hard, never a complete 100 % resolution. It is like emphysema done by smokers the damage is done or like a heart attack the area of the infarction is heart muscle now scared and the damage is done, so its get the organ to its optimal level of functioning.
  • You may have a test that lets your doctor look at a picture of your kidneys, such as an ultrasound or CT (Cat Scan of the kidneys). These tests can help your doctor measure the size of your kidneys, estimate blood flow to the kidneys, and see if urine flow is blocked. In some cases, your doctor may take a tiny sample of kidney tissue (biopsy) to help find out what caused your kidney disease.
  • Chronic kidney disease is caused by damage of the kidneys whether the cause of it be primary a Renal or Kidney problem or a secondary, another disease or disorder that affects the kidneys in doing their job, like hyperglycemia related to a individual with uncontrolled diabetes, for instance.
  • Chronic kidney disease may seem to have come on suddenly. But it has been happening bit by bit for many years as a result of damage to your kidneys.
  • One way to measure how well your kidneys are working is to figure out your glomelular filtration rate (GFR). The GFR is usually calculated using results from your blood creatinine test. Then the stage of kidney disease is figured out using the GFR (glomelular filtration rate). There are five stages of kidney disease, from kidney damage with normal GFR to kidney failure.
  • Your doctor will do tests that measure the amount of urea (BUN) and creatinine in your blood. These tests can help measure how well your kidneys are filtering your blood. As your kidney function gets worse, the amount of nitrogen (shown by the BUN test) and creatinine in your blood increases. The level of creatinine in your blood is used to find out the glomerular filtration rate (GFR). The GFR is used to show how much kidney function you still have. The GFR is also used to find out the stage of your kidney disease your in if you have it and its to guide decisions about treatment.
  • To help diagnose Chronic Renal Failure:
  • How well your kidneys work is called kidney function. As your kidney function gets worse so do your symptoms, you may show these symptoms:
  • Follow a diet that is easy on your kidneys. A dietitian can help you make an eating plan with the right amounts of salt (sodium) and protein. You may also need to watch how much fluid you drink each day.
  • Make exercise a routine part of your life. Work with your doctor to design an exercise program that is right for you.
  • Do not smoke or use tobacco.
  • Do not drink alcohol. When kidney function falls below a certain point, it is called Kidney failure. Kidney failure affects your whole body. It can cause serious heart, bone, and brain problems and make you feel very ill. Untreated kidney failure will be life-threatening at some point.
  • When you have kidney failure, you will probably have two choices: start dialysis or get a new kidney (transplant). Both of these treatments have risks and benefits. Talk with your doctor to decide which would be best for you.
  • Always talk to your doctor before you take any new medicine, including over-the-counter remedies, prescription drugs, vitamins, or herbs. Some of these can hurt your kidneys further.
  • In complete renal failure you have 2 choices for Rx. **Dialysis is a process that filters your blood when your kidneys no longer can. It is not a cure, but it can help you feel better and live longer.
  • **Kidney transplant may be the best choice if you are otherwise healthy. With a new kidney, you will feel much better and will be able to live a more normal life. But you may have to wait for a kidney that is a good match for your blood and tissue type. And you will have to take medicine for the rest of your life to keep your body from rejecting the new kidney.    
  • Making treatment decisions when you are very ill is hard. It is normal to be worried and afraid. Discuss your concerns with your loved ones and your doctor. It may help to visit a dialysis center or transplant center and talk to others who have made these choices.