Latest Labs and Other Stuff

I had a visit with the Bariatric doctor (Monday), as well as my bi-weekly labs on Wednesday.

My visit on Monday went well. Of course, I’ve gained weight since last summer. Prior to starting dialysis last August, my weight was 185 lbs; I wasn’t looking so good (my baseline weight after gastric bypass surgery in January 2002 was 240-250 lbs). After a few months of dialysis, I was up to about 205 lbs (my “dry weight” was 93.5 kg). Now, almost 4 months after my transplant surgery, I’m 223 lbs, and seem to have leveled off there. The doctor said that they don’t like to see weight gain like this after gastric bypass, but that mine was acceptable, as long as I didn’t keep gaining. There really wasn’t much else, other than she wanted to check my Vitamin B-12 level, since I get it monthly, and also because the B vitamins are excreted by the kidneys. She also checked my Zinc level (not sure why; probably because of the expected malabsorption after gastric bypass), and my Vitamin D level, since my PTH (parathyroid hormone) was elevated the last time (106). My Vitamin B-12 was 549 (norm 243-894), my Zinc was 66 (norm 60-130), and the Vitamin D is not back yet.

My other labs are still very good. Creatinine is stable at 1.2, my Hemoglobin still climbing with the Procrit (that’s good), and my Prograf level is 8.6 (lower than last time, but still within expected range). I get labs done again in 2 weeks, and I expect that my last dose of Procrit is not far off.

I haven’t done any walking this week, as the area of skin breakdown is just healing. I haven’t worn my AFO’s in a week, but have an appointment on September 8 to get them adjusted. For the meantime, my walking is very tentative, as it wouldn’t take much for one of my feet to drop, causing me to fall flat on my face. With the likelihood of weakened bones from the kidney disease, I don’t need a broken hip or extremity. I’m anxious to get back to walking. For now, I’ve been keeping active by getting the shed in our back yard ready to paint (scraping caulk; what fun!).

Jackie started her new job this week and loves it! Actually, she started it the week before, but that week was orientation, and this week, she actually started in the classroom.  She also contacted a local university, and is planning on taking courses for Special Ed. certification (she has an undergrad in Psychology, and a Master’s in Elementary Ed). It will only be 6 courses, and a 100 hour internship. We’re hoping that at least part of her internship can be done as part of her job, but if it can’t, 100 hours is only about 17 school days (for those of us who have to work 8 hour days, that of course would be 12.5 work days).

I usually don’t discuss politics much, but it’s been an interesting year. I wasn’t thrilled with either presidential candidate, but am still interested in the process and the strategies. Despite the media hoopla (I think I read that he was featured on Time Magazine’s cover 10 times this year, vs 3 for McCain), Obama isn’t that far ahead of McCain. Prior to his speech Thursday evening, the thought amongst some was that he wouldn’t get that much of a bounce out of the convention. Then, his speech was hailed as phenomenol, and I was thinking he might get a decent bounce out of the polls (a speech is nothing more than reading words on a teleprompter; it’s how WELL you do it that sets you apart from others, and he read it well). And then came the news of Sarah Palin being McCain’s running mate. It seems to have energized the Republicans, and worried the mainstream media. We’re in for an interesting ride over the next 2 months…

Transplant Day 19

Good day yesterday. Input and output are better than the previous day, my BP today is lower (but not too low), no fever, and my weight is down another pound (that’s good). My appetite picked up a little, and I managed to get more phosphorous in yesterday via some nuts, milk, PB and J on whole wheat (peanuts and wheat have a lot of phosphorous), a protein bar (contains 20% phosphorous), some chocolate, and the cheese in the lasagna we had for dinner.

I did have diarrhea again last night; it happened 12 hours after my magnesium, yet I skipped my mag dose the night before, and no diarrhea in the morning. I’m convinced that is what is causing it. So, I only took 1 magnesium last night along with Imodium (which is an approved drug for me). So far, no diarrhea this morning.

I did have to take Tylenol #3 during the night. I got up to go to the bathroom, and my elbow and hand were very painful. I tried to get back to sleep, but the pain was just too distracting, so I broke down and took it. I was finally able to get back to sleep. Initially, the pain was a numbness/tingling/buring in my 4th and 5th fingers (suggesting an Ulnar nerve problem), and then went to my other fingers and the palm of my hand. It isn’t occurring on a regular basis, so I’m still not worried about it.

My father-in-law was blown away at the retail cost of my Valcyte ($4610 for a three month supply). However, I get an “employee discount”, so that cost is deceiving. Were I to get it from drugstore.com, 3 months of Valcyte would cost $6462.68! BTW, if you want to know what a drug costs, I usually go to drugstore.com  and search for the drug. It’s a ballpark figure, but it gives you some idea of what a drug will cost. Also, on some items, it’s cheaper to pay cash there instead of going through your insurance. For example, it was much cheaper to buy a year’s worth of fluoride there, than put it through the insurance (I can’t remember the numbers, as Kevin is no longer on it). My Vitamin B-12 injections (I’m on that from having the Gastric Bypass) cost about $15 dollars for the year (12 vials). At a local pharmacy, they are $5 a vial.

I have lab work today at 10am. I won’t know what my labs are until tomorrow. I’ll check later to see if Monday’s labs are available online (they aren’t available until the doctor “dones” them; he usually isn’t very prompt with that, but at least I know the important levels).