Is Low Diastolic Blood Pressure common with Stage 3 or 4 CKD?

Fingers crossed he will actually cooperate with his therapists.
And they will let me know what he needs help with and what he should do himself when he gets home. For years he has used 'health' to have me do everything. If I didn't he would have silent punishments for me so easier to do than have him angry all the time - which drove all the kids nuts watching. Most of the time it didn't bother me but when I was in the middle of something and asked him to wait a minute until I finished and he would then get angry I would resent the heck out of it!
He is sure that daughter and I are plotting against him, even though we do everything to keep him comfortable and safe.

Sept 14 he had a doctor's appointment at Mayo. When they checked him in his BP was extremely low as was his heart rate so whisked off to Mayo ER. Hospitalized for 4 days and then to SNF for two weeks of therapy and to adjust his medications. They immediately took him off his high BP med and changed him to one to increase his BP (I think Midodrine) - so far it has only brought it up slightly - at least out of the 40s/30s. Yesterday they decided they needed more time so extending his stay to 10 days (he was hoping to get home on Friday). Needless to say, he isn't a happy camper and trying to talk the doctor into letting him go home to die (at this point he is the only one talking about him dying). He is only eating fruit cups. His physical therapy is going well, although they mentioned him being weaker in lower body.
Going day by day at this point.

Oh Julia, I am sorry you are having to deal with his defeated attitude. I am glad he is doing the PT, do you think he will continue exercising at home, or sit down and do nothing? Can you "invent" and ice cream or shake made of a protein drink that he will eat? Ask at rehab - they have so many magical tricks up their sleeves! My daughter worked on a unit where her residents only wanted to eat about 10-11 am. The dietician invented "super French toast" that nobody refused, even the pickiest of eaters.
Hugs!
Sue

If he can do the exercised in bed he will probably continue them. Just had to cancel another appointment so have 3 more to reschedule.
He is also very good at drama (did some TV, a play and lots of commercials in his younger days). He also has a low tolerance for pain, which has him doing nothing rather than getting up and moving. Thank God he never had to have a baby!
When I follow doctor's orders and insist he get his own water, etc., he 'punishes' me for being unfeeling and mean. After 35 years of waiting on him it is really hard not to do lol. Turns out I've been an enabler 🙁 But he could come up with so many excuses - gout attack, hip and/or knee problems, backache, etc.
He claims he only can eat my cooking. Another excuse.
Super French toast sounds good.

Super French toast is essentially this batter: cream or evaporated milk, beaten eggs, protein powder, a little sugar & vanilla, poured over bread in a cake pan & soaked overnight, then baked until golden. For some it was topped with strawberries & blueberries. My daughter makes it for her kids sometimes, adding a powdered protein supplement called "Protein & Greens."

Writing about it today reminded me of feeding picky eaters, so I added extra eggs & the powder to the pancakes I made my grands for supper tonight.
Sue

This morning he thought BP in the 80s/70s is not good news. This is with taking medicine to raise his BP.
Also didn't remember son Scott calling yesterday. And his swallowing problem is giving problems taking his pills - choked on them this morning. Coughed them up and still coughing later during our phone conversation. Said he told the therapist he wasn't walking this morning as he had done enough but would do his exercises in bed, which he did.
Yesterday (phone call he doesn't remember) he told Scott he needed to be rescued as he wants to die at home and not in the NH. Scott was already to get him, take him camping (which Bill hates!) and let him die under the stars. No idea what on earth Bill told him!!! I have the feeling Bill is crying 'wolf' a lot in order to get released and sent home. He now wants me to get a lawyer and sue the NH for refusing to let him go home.
He also said he has been dropping things a lot and picking them up so the staff doesn't have to. Gather pills were among things dropped.
I have called his case manager a few times (I hate making phone calls) and get bits of information. So far they haven't initiated a phone call - just respond to mine. I don't know if this is normal or not. I have talked to a couple of his physical therapist when they were in the room with him and in that regard he has been doing well and actually seems to be enjoying most of it. He was talking about a piece of equipment he wants me to get but couldn't remember the name of it - he tried to describe it as a piece of metal bar with something that looked like a golf ball on the end and you lifted it up. Also using a resistance band which he thinks helps his back.
He was also complaining of back pain (which has been chronic) although he denied it in the hospital, saying he didn't have any pain.
No idea if his GRF figures went down again after suddenly shooting up in the hospital.
He did announce that he was going to be nicer to Robin and me when he got home. Hopefully he will keep that promise!

The suggestion of trying to find another Doctor ( Palliative Care or not ) to look and critique all the medications he is on…possibly some can be removed? I had a Heart problem a few years ago and was put on several medications (my history was never taking medications) and I became a Zombie, and basically didn’t function very well…only suggestion because he is on some meds that don’t seem for life threatening issues? Possibly if a few can be removed he would function better.

They have taken him off of some (and started others!). They did put him on Seroquel and it has made life worth living again! He actually has never met a pill he hasn't liked. Family has always teased him about it. If he sees something advertised on TV he wants it - especially supplements that might not be good for his CKD.
At the moment I have no idea what they are adjusting.

Hello: Julie Chitwood @billchitwood

I am kidney transplant recipient ( my wife donated her kidney .. for which I am eternally grateful)
here are some of info I can share with you based on my experiences prior to the kidney transplant.

CKD= Five stages of chronic kidney disease
Stage 1 with normal or high GFR (GFR > 90 mL/min)
Stage 2 Mild CKD (GFR = 60-89 mL/min)
Stage 3A Moderate CKD (GFR = 45-59 mL/min)
Stage 3B Moderate CKD (GFR = 30-44 mL/min)
Stage 4 Severe CKD (GFR = 15-29 mL/min)
Stage 5 End Stage CKD (GFR <15 mL/min)

Yes as my kidney function deteriorated over time - I did become anemic too, figured that out why it happened after the kidney transplant - basically kidney plays an important role in the red blood cell creation cycle, the kidney signals the bone marrow to produce RBC and as the kidney function reduces the signal gets weaker (is my understanding) and hence less RBC are generated leading to anemia.

I had Stage 3B around in my 50s and had my transplant @ 70, A good nephrologist can help you navigate this CKD journey.

Also Low or high BP is not desirable if one experiences Kidney GFR issues, low BP reduces the perfusion function in the kidney where as high blood pressure destroys the nephron filters of the kidney

Best Wishes

Bill is 89 and doesn't want dialysis if it comes to that or a transplant (I would doubt he would be eligible for one anyway). Weird thing was his GFR going from 42 in ER and they quickly climbing to 67 while hospitalized for 4 days. No idea what it is now.