Regarding sleeping, I wish I could sleep 12 hours a day. I never have, I never will. Since I was a kid, I remember waking up early every morning to watch cartoons. I made it a habit; there is no way I could sleep after 5: 00 am, regardless of the time I go to sleep, or what I did during the day.
Regarding you going to school, if that is what you wish to do, I say go for it. Dont let PKD stop you. You may need to go on a slower pace because of health issues, you may not. You will decide this when the moment comes. But dont let PKD stop you.
PKDAD

I also have bipolar disorder and anxiety...its tough...i sleep 10-12 hours a night and an hour between my jobs and im still always tired...i wake up tired and struggle all day...i dont have a solution for u :( but curious to see if anyone does...take care :)

I am at about 22% and I am tired most all the time. I could very easily sleep for 10 hours a night and come home from work and take a nap. I just recently cut my hours at work from 40 hours to 32, because I was falling asleep at my desk. I also have a "crash day" where I sleep for nearly 24 hours. That usually happens if I have been really busy for weeks on end. They my body just can't take it any more. Plus, I do take meds for depression as well. But the tired has really become more of an issue since my kidney function has declined.

Unfortunately I have no great advice other that plan naps and don't over do it. The hardest thing for me is that people (including my family) don't "see" me as being sick. They don't understand that just vacuuming can take it out of me. I get muscle fatige as well as sick to my stomach if i over do it. But it is really hard when a person doesn't look sick, for people to understand that you are sick. Grrrr.

Hang in there,
Kelly

Spooky,
Congratulations on your choice of study at university; nursing is a wonderful profession. I don't know how your particular nursing program works, but many of ours here in the US (at least the four year baccelaureate programs start with academics for the first year and then progress to a combination of academics and practicums, which involve direct patient contact and being on your feet for up to 8 hours at a time. Are you up to the 8 hours of standing and moving around at a time right now? It's just something to consider when looking at areas of study at the university (it doesn't mean nursing will never be an option, it may just mean that you may want to look at a different course of study right now, perhaps health and patient advocacy, and take all of the prerequistites for nursing (anatomy and physiology, chemistry, ethics, etc., with the approval of the nursing department, and delay the practicums until you're physically able to participate fully in the courses). In addition, you will need vaccinations, such as Hepatitis A and B (which you should be getting now anyhow) as well as pneumonia vaccinations, to avoid getting any of these infectiosn from your patients (most US programs require the full Hep B series be completed before a student starts any hands on patient care; it's a series of 3 vaccinations over the course of 6 months). I only know because I also looked into the nursing and advanced entry to nurse practitioner programs as a second career after retiring form the Air Force, but my physical condition simply prohibited me from participating in the practicums (I also have the massive liver presentation) so I've delayed my dreams. But even post tranpslant, you can still become a nurse; there are just some specialities you'll want to avoid (e.g infectious diseseases) and some additional personal precautions you'll want/need to take to maintain your own health (more hand washing, using a mask to protect yourself as well as your patients from infections, etc.). Many nurses with transplants choose to go into trnasplant nursing; they have such a personal connection with the field.

There is no specific way you "should" feel when you have 21-30% function. Everyone is different and we each experience declining kidney function in our own way. Some people would be exhausted and have problems with both potassium and phosphorous; others may have no symptoms as all. I am sitting quite soundly at 30% and have intermittent anemia (I've been on Aranesp for the anemia for nearly 8 years intermittently; some months I need it, some months I don't). I'm tired, but I'm also carrying also have the massive liver presentation, so I'm carrying an extrra 30 odd pounds of excess liver plus at least 10 pounds of extra fluid (I find taking the diuretic causes my potassium levels to plumment too low and I get severe leg cramps, so I just deal with the fluids, which are more in my lower abdomen and upper legs due to my particular disease presentation than in my ankles and lower legs like most patients).

I will admit I would love to be able to sleep 12 hour per night, and at times I do, but it's due to a combination of pain medications and medication prescribed for sleep and depression (not bipolar). But I can also see where that could be very disruptive when you want to carry on a regular life and participate in a normal life on a normal schedule (my stepdaughter is also bipolar and has challenges with sleep, too much when she's well medicated, too little when she's undermedicated and trending towards mania). While many of us wish we could sleep that much every night (I still have a very large sleep deficit from years of getting 4-6 hours of sleep for years), it's not always what it's cracked up to be, especially if you're groggy in the morning as well.

Your neph probably asked about employment as a way of gauging how you're feeling and how much you're able to do both physicially and mentally right now. When a doctor asks a question()s and the reason for the question isn't apparent, feel free to ask them why they're asking! Medicine is an art and a science and the communication involved is a two-way street, so never hesitate to ask why you're being asked a specific question. Be the proverbial two year old and keep asking questions. One of the things I constantly do is challenge my nephrologist, not in the sense of questioning his decisions (although we do have discussions about some of those as well), but by asking questions and keeping up on my condition (e.g. at my appointment on Tuesday we discussed increased pain management and I added having another sleep study after increasing the pain medication to ensure I wasn't suffering from any increased bouts of central apneas, a side effect of sustained release pain medication...I need more pain relief, but also provided a possible solution to his concerns about giving me too much medication to the point I won't wake up the next morning).

You'll also want to get all of your lab results, not just the eGFR. Knowing your creatinine and BUN, as well as your potassium and phosphorous, your PTH, hemoglobin and hematocrit are all important and the combination tells a story beyond just the eGFR (and if you're not familiar with what they all mean, we can help you with the numbers, even with metric versus standard numbers). Low hematocrit and hemoglobin levels can increase exhaustion and contribute to extended sleep times as they mean your body doesn't have as much oxygen circulating in your blood stream (so your brain and the rest of your body isn't getting as much oxygen as it's used to or should be). Parathyroid hormone (PTH), which can increase as the kidney function decline, can also contribute to exhaustion; untreated it can cause fatigue as well as other symptoms such as nausea (or none at all).

It's also important to remember we're a system of systems, not just a set of kidneys, so your GP should be keeping an eye on your thyroid, especially with some of the medication for bipolar (they can cause some problems with thyroid levels). Everything that happens in our bodies isn't always caused by our kidneys, so we need to ensure our doctors keep an eye on our entire bodies, as well as keep an eye on our medications (renal dosing is critical for medications; I know it's a challenge, but please be sure to work with your GP and psychitrist to ensure your bipolar medication is dosed appropriate for your kidney function; adjustments often need to be made as your kidney function declines so you aren't overmedicated and don't become toxic on the medication). Some doctors tend to forget or ignore the kidneys when it comes to medications (not all medications have a renal dosing, but always ask; better safe than toxic!).

Bottom line, only you know if you're taking on too much with the nursing program. I would talk with the university advisor and find out exactly what the program involves (to include any medical requirements, a clearnace from your physican and vaccinations). Discuss your personal situation and how much you want to become a nurse and find out how much they'll be willing to work with you on the program, giving you a sabatical on the practicum if needed or allowing you breaks during practicum as needed. There is a world wide shortage of nurses, so most programs are more than happy to work with students with a strong desire to become a nurse and willingness to learn and work with the university on the courses. And most universities don't require you to take a full course load every term, so you may want to start as a part-time student and see how that goes before committing to full time status. Talk with the nursing program advisor and hopefully they'll welcome you with open arms and be more than happy to work around any limitations you may have.

I wish you well. Good luck with your decision.

Lots of hugs,
Ruth

I was very much like Kelly before my transplant. I was very tired much of the time and struggled with nausea (throwing up at least once or twice a week). but I didn't have much pain.

I needed to sleep 8 to 10 hours per night, rest regularly and take an afternoon nap. And as my function decreased I found that even after sleeping I didn't feel refreshed or energized.

Thanks you all who replied with wonderful advice.
Ruth, I can't believe how much time you put in with your reply. You must have a giant heart. Thank you and hugs to you. You are correct, i do need to ask more questions......i think the problem is my Neph always errs on the positive attitude and I don't want to appear as a worry wort. I just have to remember one of my favourite sayings .."what others think about me is none of my business"

((((((HUGS))))))