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Transplant Surgery Appt, Labs February 2009

February 25, 2009 Leave a comment

I had my bi-monthly appointment with the Transplant Surgeon last week, and everything is status quo. Dr. Varma even kiddingly said “everything is TOO perfect”. I hope he didn’t jinx me. I do have a cold this week, but no fever, and I haven’t missed any work.  I did have some problems on Sunday and Monday, as Jackie used a powdered carpet cleaner last weekend, and my airway tightened up, but that’s better now.

My labs continue to be excellent. Dr. Varma did mention that my HDL could be higher; that’s done by exercising. I did start back to walking again, so the next one should be higher. He asked me what the number 1 cause of chronic rejection is at 5-6 years. I guessed non-compliance with meds. Wrong-it’s cardiovascular disease. Hence, the gentle reminder that my HDL should be a little higher.  My Prograf level (not yet back at appointment time) is a little lower than the 6-8 range they shoot for, but I didn’t get any calls to change the dose, so it must be OK. I also had an Immune Cell Function test (Cylex); not sure what those results are yet as well.

I did ask about that test. It does a level of ATP, which the immune cells use as “energy”. The higher the number, the less immunosuppression; the lower the number, the more immunosuppression.  They shoot for about 300 at this point (probably lower target in the first 6 months). Mine was 200 last month, but they didn’t change anything.  This test also can detect cheating, or non-compliance with meds (not an issue with me). I guess some people “cheat” and only take their meds prior to labs. WHY anyone would do this is beyond me, but it’s done.

My sister had a close call 2 weeks ago. She does dialysis on M-W-F, and when she went to dialysis on Monday, her graft was clotted (her dialysis access). They couldn’t get her in to the Interventional Radiology department until the next day, so she went 4 days without dialysis. When she got to IR on Tuesday, her heart rate was 30, and she wasn’t looking too good (surprise surprise).  They took her right to the ER (right around the corner), put an IV line in her groin, and did emergency dialysis. It turns out that her Potassium was 7.1! This is a potential lethal level. Potassium regulates muscle function. Too low leads to muscle weakness, too high, and the muscles go into spasm (more or less). The heart is a muscle, so you can imagine the implications. She is fine now, but spent over 14 hours in the ER. Someone dropped the ball, as she was never given Kayexelate at dialysis on Monday; this med lowers potassium, and is used in such situations.

Jackie is doing well in her new job; she loves it!  She has been stressed lately, as she has an IEP due (her first one), midterm exams at college as well as some papers, etc., but she says it’s a “good” stress. 

I handed in my 2 week notice at my weekend job. Since Jackie’s pay has increased above what I make on the weekend, and I’ve been working just about every weekend for the past 11 years, I decided it’s time for a well-deserved break. 

Labs:

BUN 27 6-20 mg/dL H
CREATININE 1.2 0.7-1.5 mg/dL  
SODIUM 139 135-146 mmol/L  
POTASSIUM 4.1 3.5-5.1 mmol/L  
CHLORIDE 106 98-111 mmol/L  
CO2 23 22-32 mmol/L  
GLUCOSE 91 70-120 mg/dL  
ANION GAP 10 7-15 mEq/L  
CALCIUM 8.9 8.3-10.5 mg/dL  
GFR ESTIMATED >60.0 >60-  mL/min  
WBC 4.89 4.00-10.80 K/uL  
RBC 6.23 4.50-5.25 M/uL H
HGB 12.3 14.0-16.5 g/dL L
HCT 38.9 40.0-47.0 % L
MCV 62.5 82.0-99.5 fL L
MCH 19.8 27.0-34.0 pg L
MCHC 31.7 32.0-36.0 g/dL L
RDW 17.6 11.5-15.5 % H
PLATELET COUNT 182 150-400 K/uL  
MPV 8.4 6.6-11.1 fL  
SEGS 49 40-75 %  
LYMPHS 38 18-42 %  
MONOS 10 1-11 %  
EOS 2 0-6 %  
BASOS 1 0-2 %  
ABS. SEGS 2.39 1.8-7.7 K/uL  
ABS. LYMPHS 1.86 1.0-4.8 K/uL  
ABS. MONOS 0.49 0.0-1.1 K/uL  
ABS. EOS 0.10 0.0-0.7 K/uL  
ABS. BASOS 0.05 0.0-0.2 K/uL  
RBC MORPH ANISOCYTOSIS  –     
RBC MORPH MODERATE  –     
RBC MORPH MICROCYTOSIS PRESENT  –     
RBC MORPH POLYCHROMASIA  –     
RBC MORPH SLIGHT  –     
RBC MORPH OVALOCYTES  –     
RBC MORPH MODERATE  –     
RBC MORPH TARGET CELLS  –     
RBC MORPH FEW  –     
FK506 GMC 5.6  –  ng/mL  
HOURS FASTING 12  –  hours  
TRIGLYCERIDES 99 60-290 mg/dL  
CHOLESTEROL 145 <200-  mg/dL  
HDL 35 40-59 mg/dL L
CHOL/HDL RATIO 4.1  –     
LDL (CALCULATED) 90 0-100 mg/dL  
MAGNESIUM 1.9 1.4-2.8 mg/dL  
PHOSPHORUS 3.6 2.5-4.8 mg/dL  
PTH, INTACT 68 15-65 pg/mL H

Transplant Appointments Today (7/23/08)

July 23, 2008 3 comments

I had my monthly appointments with the Transplant Surgeon and the Transplant Nephrologist today. They both said I look GREAT, and there are no major issues.

My labs are still stable and the new kidney is working well. In addition to the regular labs, I also had an Immune Cell Function test done as well as a level to see if I have CMV from the donor kidney, but those won’t be back today. The immune cell function test is a guideline to make sure both that I’m taking my immunosuppressives and that the doses I’m getting are doing what they are supposed to. The CMV “titer” is to determine if the kidney I received that was CMV + has caused me to get CMV. They lowered the Valcyte dose (due to my white blood cell count dropping); this med is used to prevent me from getting CMV, so it will be interesting to see the result.

If you look at my labs, you’ll see that my hemoglobin is stable, but low. The nurse said that they would expect my hemoglobin to be at least 10 by now. However, the Nephrologist decided to put me back on Procrit for a while, to “bump up” my hemoglobin. He wasn’t at all concerned; in fact, he said that since I have Beta Thalassemia, my hemoglobin might take a little bit longer to increase back towards normal.

Other than that, I have labs in 2 weeks, and a return appointment in 3 weeks (it should have been a month, but they didn’t have any appointments on that day).  At the next appointment, I’ll have my 3 month follow up labs to check for Hepatitis B and C, and HIV, since my donor died of a drug overdose. I don’t anticipate any problems. In September, I’ll also be rechecked for BK virus.

If you’re having problems with a low cholesterol or need to gain some weight, this might be the answer.