Archive for October, 2009

Kidney Transplant Month 17

October 18, 2009 10 comments

I had my quarterly appointments with the Transplant Surgeon and Transplant Nephrologist this past week.

The Surgeon was pleased overall.  My creatinine is rock stable at 1.1, my hemoglobin, although still low (I don’t think it will ever be normal), is up from 12.7 to 13.5, and my Prograf level is at 9.5 (still on the high side, but lower than last month’s 9.9).

He also noticed my dialysis fistula, as it’s quite huge.  The other Transplant Surgeon is the one who “specializes” in these, and told me that as long as it isn’t bothering me, he wouldn’t do anything with it, as I asked to keep it for as long as I could.  Not because I plan on going back on dialysis, but because I use it to draw my own blood each month, as the veins in the other arm are crappy. When I do get it “tied off” (it is created by joining an artery and a vein side by side; the arterial pressure enlargens the vein, allowing a large needle to be used for dialysis), I will need to have the vein removed.

The only downside in my labs is the level of BK virus in my blood.  It rose from the 900 level to 1200 this month.  Still not bad, and like anything, there could be fluctuations from time to time.  In conjunction with that, my ICF (Immune Cell Function) is up to expected range of 250.  3 months ago it was 112, which is low, and indicates over-suppression (which allows opportunistic infections such as BK virus to potentially worsen).  Labs again next month; we’ll see than.

The appointment with the Transplant Nephrologist was just a “hi, how are you doing, everything looks good,  see you in 3 months” visit. (although we did chat about non-medical things)

I’ve made the decision to get the Swine Flu vaccine.   I did ask the Transplant Coordinator (RN) what the recommendation is, and the answer she gave me was non-committal.  The bottom line is that whatever we do is our decision.  For me, that’s no problem, but I think they should provide better guidance, as many patients don’t have the knowledge base to make an informed decision on it (I don’t say that demeaningly)

Judging from the phone calls I take at work from worried and confused parents, not only is there an overwhelming amount of information on Swine Flu vaccine, and quite a bit is misinformation.  I do my best to give them the information available, and help them to sort things out.

Back to my decision, if I were to get Swine Flu, it could be more serious due to being immunocompromised, as well as having a chronic neuromuscular disorder.  I have a higher probability of infection as well, given that I work as a nurse and am thus exposed to it more  (although I’m diligent with handwashing and using a mask when needed).

The Swine Flu infection has thus far proven to be fairly benign, based on what I see clinically in our outpatient Pediatric Clinic, but the virus can always mutate, and become more virulent.  Granted, the vaccine wouldn’t be composed of the mutated strain, but there’s a possibility (theoretically)  that it could provide some cross protection.  The Swine Flu virus is comp0sed of 3 different influenzas: swine (pig flu), human, and avian (bird flu). It’s that last one that’s particularly scary.

As I understand it, the Swine Flu vaccine is the same base vaccine as that for Seasonal Flu (there is now a Seasonal Flu vaccine shortage as they had to suspend production to switch over to producing Swine Flu vaccine).  I’ve gotten Seasonal Flu vaccine for years now, and never had a problem. The difference between the 2 is strictly the difference in strains of influenza that it contains. If you do decide to get it and have a chronic illness, be sure to get the injectable vaccine;   the nasal spray vaccine (FluMist) contains a live virus.

Last weekend, I worked a double shift in the hospital; it took 2 days to recover!  Anyway, one of my patients was an infant who had congenital blindness, but also newly diagnosed chronic renal failure.   Amazingly, she survived a potassium level of 9.2!  It was found on a routine screening lab by an eye doctor. When Jackie and I took my sister to the Emergency Department for weakness, she had a potassium of 7.3, and was in complete heart block (the electrical signals to the heart weren’t able to fire right due to the high potassium), and probably almost coded.  They had the external pacer pads attached to her, the code cart in the room, and she had to have emergency dialysis.   That just goes to show how resilient kids can be.


New addition to the family

October 14, 2009 5 comments

Our son Kevin phoned my wife a week ago, telling her he was on his way home, and asked if we wanted a new dog.  When he got home 5 minutes later, he brought home a puppy.  Of course, there was no decision to be made;  it was a done deal before he even got home.

He was at a friend’s house, when an acquaintance of his friend pulled up to the house with a dog in his car.  The acquaintance was a 19 year old living in an apartment on his own, and “couldn’t afford to feed her anymore” (or so the story goes).  We found out later that he was probably going to shoot her rather than take her to the SPCA, as there was a waiting list for dropping off dogs, and a cost as well. We also found out that she spent the majority of time in a crate.  (it’s not uncommon in this rural area for farmers to shoot a dog once it’s outlived it’s usefulness-NOT something I would ever even consider)

Kevin didn’t want to see the dog put down, so he asked if he could have her.  And that’s how we got Chloe.

She’s a Laberaner (my term); that is, a Labrador Retriever/Weimeraner mix.  You would think that she would be huge, but she’s actually very petite.  I’d say she’s about 50 lbs at most, and undernourished as well.  Her ribs are clearly visible, but we’ve had her for about 10 days now, and she eats like a horse.

The only potential problem is that we have a 3 year old male GoldenDoodle, who wasn’t neutered.  Digger went  to the vet this past Monday and that’s since been fixed (pun intended).

Digger and Chloe get along GREAT.  They play together until they’re exhausted (good for both of them); Digger LOVES his new playmate.  Our 13 year old Springer Spaniel is a different story.  She let Chloe know early on that she will not tolerate any nonsense, and Chloe steers clear of Kelsea.

We keep Chloe in a crate during the day when we are at work.  Based on experience, sporting dogs can’t be trusted (as far as chewing) until 2-3 years of age.  Chloe will be 1 year old on Halloween, so she still has another year or 2 of the crate.

Here are pics of our dogs:





Chloe and Shamrock

Chloe and Shamrock

Digger after ridding our yard of a rabbit

Digger after ridding our yard of a rabbit

Kelsea, our elderly Springer Spaniel

Kelsea, our elderly Springer Spaniel