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Archive for May, 2008

Transplant Day 26

May 29, 2008 Leave a comment

Not much to report since my last post, although I’m not sleeping well the past2 nights. Who knows; med side effect?

My vital signs are essentially unchanged. My weight fluctuates, but averages around 210 lbs. As long as I don’t gain more than a pound or 2, I’m OK with that.

I did try toput jeans on, but couldn’t get them buttoned. My abdomen is a little swollen from the surgery, and the nurse told me that it will take several months for it to go down, not to mention the fact that you can see the kidney somewhat jutting out. We’re going tonight to get a pair in a larger size, as well as some shorts for the summer, since most of mine don’t fit.

Yesterday when I got home from the doctors’ appointments, we went to lunch, and then I came home again and fell asleep forover 3 hours! Fortunately, I have the time to do that.

I’ve also found that my appetite hasn’t been the best. I ate breakfast after my labs, and had almost a whole piece of toast, some scrambled eggs (which I didn’t finish), and chocolate milk (not a huge fan of this, but I needed a cold drink to take my meds, and I needed the phosphorous; otherwise, I would have had a coffee). I guess there’s a reason they tell us “small frequent meals” right after the transplant.

The one thing I’ve been doing is reading. A friend bought me some books, and I just finished the first: Consent To Kill by Vince Flynn. I now have a new favorite author! I have a bunch of unread history-type books, and although I enjoy history, it’s not near as exciting to read as a spy thriller such as this. When I was a kid, I used to read all of the time. In High School, my favorite author was James Michener. I’ve read Chesepeake, Texas, Centennial, Tales of the South Pacific, Hawaii, and possibly some others I don’t remember. I always said that if you get through the first 100 pages of any of his books, you’ll then get to the good part (he goes into a long drawn out history of the area from prehistoric times to the time the story starts).

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Categories: Uncategorized

Transplant Day 26

May 29, 2008 1 comment

Not much to report since my last post, although I’m not sleeping well the past 2 nights. Who knows; med side effect?

My vital signs are essentially unchanged. My weight fluctuates, but averages around 210 lbs. As long as I don’t gain more than a pound or 2, I’m OK with that.

I did try to put jeans on, but couldn’t get them buttoned. My abdomen is a little swollen from the surgery, and the nurse told me that it will take several months for it to go down, not to mention the fact that you can see the kidney somewhat jutting out.  We’re going tonight to get a pair in a larger size, as well as some shorts for the summer, since most of mine don’t fit.

Yesterday when I got home from the doctors’ appointments, we went to lunch, and then I came home again and fell asleep for over 3 hours! Fortunately, I have the time to do that.

I’ve also found that my appetite hasn’t been the best. I ate breakfast after my labs, and had almost a whole piece of toast, some scrambled eggs (which I didn’t finish), and chocolate milk (not a huge fan of this, but I needed a cold drink to take my meds, and I needed the phosphorous; otherwise, I would have had a coffee).  I guess there’s a reason they tell us “small frequent meals” right after the transplant.

The one thing I’ve been doing is reading. A friend bought me some books, and I just finished the first: Consent To Kill by Vince Flynn. I now have a new favorite author! I have a bunch of unread history-type books, and although I enjoy history, it’s not near as exciting to read as a spy thriller such as this. When I was a kid, I used to read all of the time. In High School, my favorite author was James Michener. I’ve read Chesepeake, Texas, Centennial, Tales of the South Pacific, Hawaii, and possibly some others I don’t remember. I always said that if you get through the first 100 pages of any of his books, you’ll then get to the good part (he goes into a long drawn out history of the area from prehistoric times to the time the story starts).

Transplant Day 25, Appointments

May 28, 2008 Leave a comment

Feeling better each day. The minor issues I’ve had along the way; edema, arm pain, diarrhea, incisional pain, etc are all but resolved.

My daily vital signs are all good today. I also updated my labs, since they are now finally available to me online.

I had my weekly appointments today, which is why I’m posting later than usual.

They had difficulty drawing my blood today, but with what they had to work with, I’m not surprised. They ended up using “old faithful” (a small vein on the outside of my arm just below my elbow).

The Transplant Nephrologist was in first. His main concern is my anemia, and he is right on top of it. He thanked me for being “proactive”, as I had emailed him over the weekend to explain my ongoing iron situation, and had requested labs to check on it. Since he’s only seen me once since my transplant, I wanted him to know of the ongoing iron problem. He took the time to explain that due to my gastric bypass surgery, I probably malabsorb iron. Iron requires an acid environment (most of my stomach is stapled off, and my “pouch” may not produce enough acid to absorb iron; in addition, my acid secretions are decreased due to the Prilosec), and it also requires the parietal cells in the ileum(portion of the small bowel) as well (my bypass is before the ileum). The plan is to watch the trend of my iron studies, and if still abnormally low, that I may need monthly IV infusions of iron.

As it turned out, my studies are all normal today, with the exception of my iron binding function, which is minimally below normal. So that is good. My hemoglobin is stable but low, and my hematocrit is fairly stable, although a bit lower than last week. I think that they said that I would need Procrit if the hematocrit goes to 25 or below, so there’s still some room there. And I’m less concerned, because my hemoglobin is unchanged, so maybe the new kidney is producing erythropoietin now. Also, he discussed my white blood cell count, which is low. That is due to the Valcyte and CellCept. However, he explained that since my segs were high, I’m more or less protected from viruses, but since I had “Campath Induction” ,my T cells were essentially wiped out, making me more susceptible to bacterial infections such as TB.

The Transplant Surgeon was in last, and was very pleased with both my labs and myprogress. They did a lab called an Immune Cell Function last week. As it was explained to me, this is a guideline for them to use to determine the amount of my immunosuppression, and it is “right on” where they want it. My phosphorous and magnesium are now both within normal, so I can stop the Magnesium Oxide-yea! My Prograf level (FK-506) is finally normal, so I assume my dose stays the same (this wasn’t back until after my appointment).

I did print out my “daily vital signs” spreadsheet, and the Transplant Nurse told the surgeon I’m “anal”. I agree, however, I also did it to occupy my time as well. But I think that the surgeon is more comfortable with me making sure that I do what I need to do, because he told me that I can come back in 2 weeks, instead of 1 week.

I also asked him about my cystoscopy next week (I’ll be getting my stent out). My concern is that I may get an infection, which will travel to my native kidneys. He said that he would prefer not to give an antibiotic beforehand, because that promotes resistance. If I had a problem with my heart valve, then yes, he would, but not in this case.

I’m excited about a new blogging opportunity. I will be writing for a website that will have multiple bloggers writing on various aspects of kidney disease. I will be writing as a new transplantee. There are also future plans to expand the site, and I will probably be writing as a medical professional. I will post more details when things are up and running.

Cross posted at WordPress.

Categories: Uncategorized

Transplant Day 25, Appointments

May 28, 2008 5 comments

Feeling better each day. The minor issues I’ve had along the way; edema, arm pain, diarrhea, incisional pain, etc are all but resolved.

My daily vital signs are all good today. I also updated my labs, since they are now finally available to me online.

I had my weekly appointments today, which is why I’m posting later than usual.

They had difficulty drawing my blood today, but with what they had to work with, I’m not surprised. They ended up using “old faithful” (a small vein on the outside of my arm just below my elbow).

The Transplant Nephrologist was in first. His main concern is my anemia, and he is right on top of it. He thanked me for being “proactive”, as I had emailed him over the weekend to explain my ongoing iron situation, and had requested labs to check on it. Since he’s only seen me once since my transplant, I wanted him to know of the ongoing iron problem. He took the time to explain that due to my gastric bypass surgery, I probably malabsorb iron. Iron requires an acid environment (most of my stomach is stapled off, and my “pouch” may not produce enough acid to absorb iron; in addition, my acid secretions are decreased due to the Prilosec), and it also requires the parietal cells in the ileum (portion of the small bowel) as well (my bypass is before the ileum).  The plan is to watch the trend of my iron studies, and if still abnormally low, that I may need monthly IV infusions of iron.

As it turned out, my studies are all normal today, with the exception of my iron binding function, which is minimally below normal. So that is good. My hemoglobin is stable but low, and my hematocrit is fairly stable, although a bit lower than last week. I think that they said that I would need Procrit if the hematocrit goes to 25 or below, so there’s still some room there.  And I’m less concerned, because my hemoglobin is unchanged, so maybe the new kidney is producing erythropoietin now.  Also, he discussed my white blood cell count, which is low. That is due to the Valcyte and CellCept. However, he explained that since my segs were high, I’m more or less protected from viruses, but since I had “Campath Induction” , my T cells were essentially wiped out, making me more susceptible to bacterial infections such as TB.

The Transplant Surgeon was in last, and was very pleased with both my labs and my progress. They did a lab called an Immune Cell Function last week. As it was explained to me, this is a guideline for them to use to determine the amount of my immunosuppression, and it is “right on” where they want it. My phosphorous and magnesium are now both within normal, so I can stop the Magnesium Oxide-yea! My Prograf level (FK-506) is finally normal, so I assume my dose stays the same (this wasn’t back until after my appointment).

I did print out my “daily vital signs” spreadsheet, and the Transplant Nurse told the surgeon I’m “anal”. I agree, however, I also did it to occupy my time as well. But I think that the surgeon is more comfortable with me making sure that I do what I need to do, because he told me that I can come back in 2 weeks, instead of 1 week.

I also asked him about my cystoscopy next week (I’ll be getting my stent out). My concern is that I may get an infection, which will travel to my native kidneys. He said that he would  prefer not to give an antibiotic beforehand, because that promotes resistance. If I had a problem with my heart valve, then yes, he would, but not in this case.

I’m excited about a new blogging opportunity. I will be writing for a website that will have multiple bloggers writing on various aspects of kidney disease. I will be writing as a new transplantee. There are also future plans to expand the site, and I will probably be writing as a medical professional. I will post more details when things are up and running.

Medical Article Scan May 2008

May 27, 2008 2 comments

Here are some interesting articles from this past month:

Supplement Your Knowledge of Vitamin D – While looking up some information on one of my meds, I found this article. It’s actually directed at a general audience (as opposed to those with kidney disease).

Bye Bye Biopsy – there is now an alternative for those of us with transplants who may face a biopsy; a genetic test that is done from a blood sample. This test can also be used for a variety of other biopsy related situations.

New York Planning Special Ambulance To Recover Organs – on the surface, this looks like a great idea, but I think it will do more harm than good. To quote from the article: “People are going to worry when the ambulance comes out to their house whether they are there to care for them or to take their organs.”  And this is where the problem lies; there are a good amount of people who will not sign the donor card for fear that they will be in an ED, and the doctor will pronounce them brain dead in order to get their organs, when they may not be brain dead. I don’t believe this to be true, but the thought is still out there, and this plan could potentially make things worse.

Daily Doses of Bach and Breathing Lower Blood Pressure – The title is a bit misleading, as it’s not only music by Bach that had an effect. Being a former music teacher, this is right up my alley (although one physician interviewed felt that it was primarily the breathing that had an effect). And even though it only had an effect on systolic pressure, it’s a treatment that has no side effects, so what can it hurt?

 Early Insulin Hit Leads To Diabetes Remission – This is a very interesting study of using intensive insulin treatment for newly diagnosed Type 2 diabetics (non-insulin dependant aka “adult onset diabetes), although the study is limited.

Home Monitors Advised For Hypertensive Patients – in my opinion, this is an excellent proposal. It seems odd that physicians will base anti-hypertensives on bp readings limited to when to when the patient is in the office. There are far to many variables to depend on this. If bp is taken at home, it can be done once or twice a day, and it will be easier to spot trends. Also, I’ve found that the electronic machines are a waste. I bought a cuff that has a stethoscope attached, and it is much more accurate. And for those not trained to take a bp, as long as you can hear well, it’s easy to learn.

Experts Question Placebo Pill For Children – I don’t think this is a good idea. After all, a parent needs to build trust with their child/children; once the child finds out that the parent has tricked them, what does that do to their sense of trust?

 

Transplant Day 24

May 27, 2008 Leave a comment

Feeling better today. Not as much fatigue, and no longer feeling cold (of course, it got up to the mid 80’s here yesterday, so that helped).

My weight is up a pound from yesterday, BP is great, and I had more in than out, but I’m still putting out almost 100 cc’s of urine per hour; must be more of the insensible losses.

Last night, I was able to sleep on my side, rather than in the recliner, which is a first since the surgery. The only problem was that I was only able to sleep on my right side, and my right arm “fell asleep”, and was somewhat painful when I woke up. I tried switching to my left side (the side the kidney is on), but that didn’t work. One of the long-standing sleep issues I’ve had is sleep position. I always slept on my side, but as my kidneys enlarged from my cysts, I ended up having to switch sides multiple times per night. That’s still an issue, but last night, I just alternated between switching from my right side to my back, and that seemed to work.

My “natives” (the term for a person’s kidneys that they were born with, as opposed to the transplanted kidney) are still in, but hopefully will shrivel up to nothing. I expect to lose a good amount of weight when that happens, as each kidney can weigh up to 40 lbs each .

Categories: Uncategorized

Transplant Day 24

May 27, 2008 1 comment

Feeling better today. Not as much fatigue, and no longer feeling cold (of course, it got up to the mid 80’s here yesterday, so that helped).

My weight is up a pound from yesterday, BP is great, and I had more in than out, but I’m still putting out almost 100 cc’s of urine per hour; must be more of the insensible losses.

Last night, I was able to sleep on my side, rather than in the recliner, which is a first since the surgery. The only problem was that I was only able to sleep on my right side, and my right arm “fell asleep”, and was somewhat painful when I woke up. I tried switching to my left side (the side the kidney is on), but that didn’t work. One of the long-standing sleep issues I’ve had is sleep position. I always slept on my side, but as my kidneys enlarged from my cysts, I ended up having to switch sides multiple times  per night. That’s still an issue, but last night, I just alternated between switching from my right side to my back, and that seemed to work.

My “natives” (the term for a person’s kidneys that they were born with, as opposed to the transplanted kidney) are still in, but hopefully will shrivel up to nothing. I expect to lose a good amount of weight when that happens, as each kidney can weigh up to 40 lbs each .