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Posts Tagged ‘kidney failure’

Hospitalization May 2011

May 14, 2011 3 comments

What a difference 3 weeks make (since my last post).  At that point, I had just gotten home the day prior from the hospital after my foot surgery, and had been prescribed Fluconazole (aka Diflucan).

This past Wednesday, I went in for my routine quarterly transplant appointment that had been postponed a month due to my surgery.  It wasn’t a good week; our 15 year old Springer Spaniel died on Monday, and my son locked the keys in our vehicle when I was going to my transplant appointment.  When the Transplant Nephrologist came in, he looked at my labs, and had a look of surprise on his face.  While my creatinine usually runs between 1.1 to 1.3, it was 2.1, with a GFR of 34%!  I was admitted to the hospital that day for Acute Renal Failure, and was in for 2 nights.  I had a renal ultrasound, and there was no obstruction, and my transplanted kidney has good blood flow.

It turns out that I went into failure from Prograf toxicity (level of 21.8!).  In addition, my BK virus, which was 7000 copies in my urine last month (mistakenly reported at that time in last month’s post as 7700), shot up to 912,000 copies on Wednesday, no doubt from the oversuppression from the high Prograf level.  This was all due to an interaction between the Prograf and the Fluconazole.

At this point, they decreased my Prograf from 3mg in am and 2 mg in PM, to 2/1.  I will have labs next Thursday, and if my creatinine is improved, they will probably just watch it for now. If it isn’t improving, I’ll be getting a kidney biopsy. “Chronic disease with a positive attitude”  is a bit difficult this week, but I’ll keep trying.

Until next time….

Attitude Is Everything

December 16, 2009 2 comments

As many of my readers know, I work in a large Pediatric clinic, and we share space with a Family Practice clinic.

Yesterday, one of my Family Practice co-workers asked me to speak to a 70 year old gentleman who has many health problems, who is “considering” getting a fistula for dialysis.  He’s ruled out getting a transplant, although he tells me his Nephrologist is encouraging him to do so.

I say considering, because he’s very down and discouraged over his overall situation.  He tells me that he had a quadruple bypass 2 years ago, and told me he will no longer shoot his shotgun because he’s afraid his sternum will rip open at the surgical site from 2 years ago (it won’t; they wire it shut, and the bones are already healed).  He has vision problems, and nerve damage to his non-dominant arm from the surgery.  His wife of 52 years was with him, and her eyes were red (I assume from crying).

I explained what a fistula is and why he needs one; a catheter is a poor choice for dialysis and only used as a temporary fix or as a last resort.  Of course, I was upbeat about the process,  as I truly believe that he will feel so much better once he starts dialysis (he didn’t say at what point he is at with his kidney failure). Compared to my other surgeries, fistula surgery was not that big a deal, as it didn’t even require general anesthesia for me; I stopped at McDonalds for lunch on the way home from the hospital.

Granted, dialysis is no walk in the park, but it sure beats the alternative.  During my 9 months on dialysis, I saw a wide spectrum of reactions to dialysis, just as there is a spectrum of how people deal with day to day life. For me, dialysis allowed me to feel SO much better, so it helped me greatly (and the transplant had exponentially even more of an effect).

I’ve had my share of medical “speed bumps”, but as you know, I’ve used my attitude and determination to overcome them. I have pain every day from neuropathy (hereditary), but don’t even think about, and rarely take pain meds (unless it gets bad)

But I could tell he’s a long way off from “believing”.   I do think that our talk did help his wife somewhat, and told both of them not to hesitate to contact me if they had any questions or needed to talk.
So for those of you who tend to have a bleak outlook, just remind yourself,  as I always do:  there is always someone worse off than yourself.  If I were this gentleman, I would be thinking of the people who go through life paralyzed, who have terminal cancer, who have mental illness that makes them outcasts in society through no fault of their own…

The key to dealing with chronic illness, enjoyment of day to day living, and survival is to be positive.  It’s an attitude that’s sometimes difficult to maintain at times, but one worth striving for.

Note: I met this gentleman not in the course of work, (I was never involved in his care, as I work in Pediatrics) and am not disclosing his name, so I feel comfortable that I am not breaching confidentiality, and only know the details above based on what he and his wife told me. I wish them both well.