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Posts Tagged ‘edema’

Transplant Day 23

May 26, 2008 1 comment

No irregular heart beats yesterday,  but I’m feeling run down, and my appetite isn’t the greatest. I did manage to get almost 3 liters of fluid in though. I think I’m catching up on my fluids, because my urine is lighter in color. I’m also at the point now that since I’ve been measuring my urine, I can accurately guess the amount within 50 ml.

My weight is up a pound from yesterday (normal variation?), my bp remains good, but I did have more fluids in than out (although not worrisome; may be insensible losses).

The arm pain is just about gone; I haven’t had pain meds for a few days. The edema in my legs is mostly resolved as well.

Something that is unusual is that every evening, I get cold. Not chills per se, but I’m just cold. We did go out for supper last night, and the restaurant was like a freezer. When I got home, I put a blanket on, even though the outside temp was about 70 degrees (F).

Although my Magnesium dose is 1 twice daily (decreased due to diarrhea), I try to get an extra one when possible; I managed to take three yesterday. 

I suspect that my fatigue is from the low hemoglobin.  Within a week it went from 10.5 to 9.7; maybe it’s even lower now. The surgeon said that he wasn’t worried about it just yet; it sometimes takes a while before the new kidney starts putting out adequate amounts of Erythropoietin.  As I mentioned in another post, I did message the Nephrologist to see if he wanted labs added on in regards to my iron level, because that’s traditionally low as well.

Happy Memorial Day everyone!

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Transplant Day 17; Appointments

May 20, 2008 4 comments

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