Posts Tagged ‘erythropoietin’

Transplant Day 25, Appointments

May 28, 2008 5 comments

Feeling better each day. The minor issues I’ve had along the way; edema, arm pain, diarrhea, incisional pain, etc are all but resolved.

My daily vital signs are all good today. I also updated my labs, since they are now finally available to me online.

I had my weekly appointments today, which is why I’m posting later than usual.

They had difficulty drawing my blood today, but with what they had to work with, I’m not surprised. They ended up using “old faithful” (a small vein on the outside of my arm just below my elbow).

The Transplant Nephrologist was in first. His main concern is my anemia, and he is right on top of it. He thanked me for being “proactive”, as I had emailed him over the weekend to explain my ongoing iron situation, and had requested labs to check on it. Since he’s only seen me once since my transplant, I wanted him to know of the ongoing iron problem. He took the time to explain that due to my gastric bypass surgery, I probably malabsorb iron. Iron requires an acid environment (most of my stomach is stapled off, and my “pouch” may not produce enough acid to absorb iron; in addition, my acid secretions are decreased due to the Prilosec), and it also requires the parietal cells in the ileum (portion of the small bowel) as well (my bypass is before the ileum).  The plan is to watch the trend of my iron studies, and if still abnormally low, that I may need monthly IV infusions of iron.

As it turned out, my studies are all normal today, with the exception of my iron binding function, which is minimally below normal. So that is good. My hemoglobin is stable but low, and my hematocrit is fairly stable, although a bit lower than last week. I think that they said that I would need Procrit if the hematocrit goes to 25 or below, so there’s still some room there.  And I’m less concerned, because my hemoglobin is unchanged, so maybe the new kidney is producing erythropoietin now.  Also, he discussed my white blood cell count, which is low. That is due to the Valcyte and CellCept. However, he explained that since my segs were high, I’m more or less protected from viruses, but since I had “Campath Induction” , my T cells were essentially wiped out, making me more susceptible to bacterial infections such as TB.

The Transplant Surgeon was in last, and was very pleased with both my labs and my progress. They did a lab called an Immune Cell Function last week. As it was explained to me, this is a guideline for them to use to determine the amount of my immunosuppression, and it is “right on” where they want it. My phosphorous and magnesium are now both within normal, so I can stop the Magnesium Oxide-yea! My Prograf level (FK-506) is finally normal, so I assume my dose stays the same (this wasn’t back until after my appointment).

I did print out my “daily vital signs” spreadsheet, and the Transplant Nurse told the surgeon I’m “anal”. I agree, however, I also did it to occupy my time as well. But I think that the surgeon is more comfortable with me making sure that I do what I need to do, because he told me that I can come back in 2 weeks, instead of 1 week.

I also asked him about my cystoscopy next week (I’ll be getting my stent out). My concern is that I may get an infection, which will travel to my native kidneys. He said that he would  prefer not to give an antibiotic beforehand, because that promotes resistance. If I had a problem with my heart valve, then yes, he would, but not in this case.

I’m excited about a new blogging opportunity. I will be writing for a website that will have multiple bloggers writing on various aspects of kidney disease. I will be writing as a new transplantee. There are also future plans to expand the site, and I will probably be writing as a medical professional. I will post more details when things are up and running.

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!