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Transplant Day 13

Each day seems to be a little better than the previous. Small steps, but noticeable. I’m able to get around more, less incisional pain/discomfort,and I’m getting used to drinking large amounts of fluid without feeling bloated.

Today’s vitals: wt 218 lbs (down 1.5 from yesterday), BP 132/82 (top number down, bottom number slightly up), Temp 97.9, and yesterday’s input was 3160 cc and output an even 3 liters (3000 cc).

I had labs yesterday morning. The tech did a great job, considering what she had to work with vein-wise. She used “Old Faithful”, which is a small vein on the outside of the top of my forearm just below the elbow crease. The blood was slow coming out, but she eventually was able to fill the 3 tubes. I still don’t have my labs back; probably because this is an “outlying” clinic, and the hospital lab probably didn’t get the blood until the end of yesterday.

The walk yesterday went well. I estimate it was about 1/4-1/2 mile each way, and I tolerated it well. I’ll continue walking every day, hopefully gradually increasing as I go along. This will serve several purposes; it will hopefully get more fluid off, I’ll be in better shape (aerobic exercise), I won’t be bottled up in the house all day, and maybe it will help my blood pressure.

I filled my med box yesterday; it took about 15 minutes to fill it for the week. By doing it weekly, I’m sure not to miss any meds.

I’m not sure yet if the Magnesium is causing stomach upset. I took my first dose Wednesday night, and yesterday, I got nauseated during lunch. I didn’t eat much until supper, and initially I was nauseated, but then was able to finish without any problem. I ate something before my bedtime dose, and was fine the rest of the night.

The arm continues to be a problem. Right now, it is very painful in my upper forearm at the elbow crease and bicep. I put heat on it when I got up, and that helped. Also, I slept with it on a soft pillow, and that also helped. But when I’m awake, it’s bothersome. The week before my transplant, one of the dialysis nurses gave me a pillow for my arm (promotional item from the manufacturer of Fosrenol); on dialysis, it’s helpful to put the fistula arm on a pillow. I left it at the dialysis unit between treatments, but made sure I took it on my last dialysis day; I’m glad I did.

I was only up once during the night to pee. Definite progress; my bladder must be stretching, because I had 600 cc output that one time. Maybe I’ll eventually be able to make it through the night without having to get up to pee!

I contacted my Bariatric doctor via email (I call him my “fat” doctor; he’s a specialist in obesity). When I had my gastric bypass, I was told that I would take a Multivitamin and Citracal for the rest of my life. When my kidneys started failing, my Nephrologist took over this aspect, because a regular multivitamin could end up being toxic, and I needed to go on a phosphorous binder, which is a form of calcium (calcium acetate). My nephrologist put me on a renal vitamin, which contains vitamins B and Folic Acid. It avoids the fat soluble vitamins, because they could build up toxic levels very easily. Now that I don’t have to take my phosphorous binder, I figured I would have to go back on Citracal, but the Bariatric doc wanted me to clear it with the transplant department. I mentioned this at my last appointment, and the surgeon wanted to know why I needed to take Citracal. I explained it to him, and he didn’t say anything. I guess I’ll have to discuss it in more detail at Monday’s appointment. I keep a running list of questions in my “Ins and Outs” notebook, so I added that question.

Pauly, a good friend of ours (he was my college roommate and best man at our wedding) has made the decision to go for weight loss surgery. He met with the surgeon yesterday, and has to decide whether he wants the Lapband or Gastric Bypass. Up until now, he wasn’t ready to do it. I had suggested it a few times, but didn’t push it, because I realize that the worst thing one can do with this decision is to have it done when they are not sure about it. I know that he is sure of it, and glad he got to this point. I can relate, because my “Fat” doctor suggested it to me, and I went to Hershey Medical Center for an eval (Geisinger wasn’t yet doing it at the time). However, I chickened out and never went back. About 2 years later, a co-worker had it done, and although she had some complications, I saw her progress, and decided to take the plunge (at that point, Geisinger was now doing the procedure). It was the best thing I ever did. If I hadn’t done it, I wouldn’t have been eligible for a transplant, and dialysis would have been difficult (there was a young large guy at dialysis that had 6 hour treatments; with that much weight, 4 hours doesn’t do it). Ironically, my Nephrologist and PCP were not what I call encouraging about it. My PCP wasn’t discouraging, but I could tell that he was skeptical of my decision. My Nephrologist told me that I should put a lot of thought into my decision; I could tell he didn’t think it was the right decision. Now, my PCP is thrilled with my progress (other than the extra fluid weight after my transplant, I’m down close to 200 lbs from my highest weight). My Neph is more positive about it now specifically with me, but I don’t think he’s totally convinced overall).

Cross posted at WordPress.

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