Transplant Day 17; Appointments

Doing well today. Stomach is MUCH better, but I did have diarrhea the past 2 days. Could be from the CellCept (very common) or the Magnesium Oxide. I’m not too worried at this point.

I had my appointments yesterday. Both doctors were pleased with the way things are going.

I first saw the nurse, and she thinks the arm pain is probably from positioning in the OR, and I agree. It is getting better, so that’s fine with me. I took less pain meds yesterday; in fact, I only took them twice from Midnight to bedtime, and only once this morning.

I have to cancel my dental appointment for a cleaning; they don’t want that done until at least 6 months from surgery due to the immunosuppression.

I also addressed the nausea/vomiting, and got a prescription for Prilosec. The Transplant Nephrologist told me to even take it twice daily for several days and then go to once daily.  My stomach is much more settled today.

I do have to drink more; my intake of fluids was about a liter under what I usually take in, and my urine is much more concentrated.
 
I wore my splints again yesterday to my appointments, since I had a lot of walking  (Geisinger is a large campus). By the time I got home, there were ridges in my legs from my socks and splints. In fact, the doctor checked, and I have 4+ pitting edema. That means that when he pressed down on my skin for several seconds (the front of my lower leg), it took more than 4 seconds for the skin to return to shape and the “pit” (depression) to resolve.

The Transplant Nephrologist said that he expects my creatinine to settle in to about 1.4-1.5. It’s still 1.6, but my Prograf levels are higher than normal (intentionally);  once they can lift up on the immunosuppression, and lower the dose, my creatinine will lower. He also said that with a 16 year old’s kidney, it should last the rest of my life! I was thrilled, because the average life of a transplanted kidney is 14 years. I understand that there are things that can change this, but optimistically, it would be great if it lasts me past retirement age.

The next time I hear a co-worker complain about our insurance coverage, I will promptly tell them about my Valcyte. I received a 3 month supply via the mail order pharmacy; my cost was $40, and the cost without the insurance was $4610.00. I’ll be interested to see the cost of my Prograf and CellCept; I sent for 3 month supplies of those (I already know that each will be a $40 co pay, but I don’t know what the retail cost is).

 My labs from yesterday are still not available to me, but the nurse told me my creatinine is stable at 1.6, my phosphorous is lower at 1.5 (the surgeon wasn’t too concerned; I just have to eat more dairy), and my magnesium is lower at 1.2(?). I’ll post them when they are available.

Next week my appointments are on Wednesday, which is the traditional “Transplant Clinic” day. So, I have to get labs “locally” on Thursday, and then again the morning of my appointments; there is a Geisinger clinic within walking distance, which is better for me; that way, Jackie doesn’t have to take off work to drive me to Danville for labs.

Here are my “vitals”. Note that on 5/8, that was the day I came home, and the next day, I didn’t realize that I had to weigh myself until I read through all of the literature they gave me. There is a lot of verbal and written info on discharge, and it’s a bit overwhelming. Also, in my free time, I’m learning Excel, so that is why it’s in spreadsheet format (I figured that now is a good time to learn it, as well as apply what I learned). Note the input and output are tallied at the end of the day, and the BP, Temp, and Weight are done upon awakening.

Date		Input	Output	BP	Temp	Wt (kg)	Wt (lbs)
5/8/2008		1040	775
5/9/2008		3320	2575	134/64	98.6
5/10/2008		3080	2300	132/64	98.5	100	220
5/11/2008		3280	2950	132/72	98.1	99.0909	218
5/12/2008		2740	2900	138/70	98	99.0909	218
5/13/2008		2680	2485	138/78	97.7	99.5	219
5/14/2008		2740	3375	132/80	96.5	99.5	219
5/15/2008		3160	3000	138/80	97.7	99.8	219.5
5/16/2008		3590	3800	132/82	97.9	99.0909	218
5/17/2008		2960	3375	138/78	97.8	99.3182	218.5
5/18/2008		2320	3500	132/68	97.7	97.2727	214
5/19/2008		2800	2275	128/70	97	96.3636	212
5/20/2008				122/62	97.8	95.4545	210