A Successful First Week

I was released from the hospital Friday afternoon after four successful dialysis treatments. They have set me up at an outpatient dialysis clinic for the Tuesday, Thursday, Saturday afternoon (about 4:30) shift. The clinic is about ten minutes from my apartment and about ten or fifteen minutes away from work. Hopefully I'll be able to go back to work soon. Being home all summer is not as great as you might think (especially when you spend all of that time in the hospital).

I had four dialysis treatments in the hospital. They started with a short, two-hour treatment on Tuesday and worked up to a 3 1/2 hour treatment on Friday. My fistula is still new, so they are using 17-gauge needles (which I am told is the smaller of the two sizes). The are also filtering my blood at a rate of about 300 cc/min, and the normal rate is at least 400 cc/min. Since I still have one kidney that sort-of functions, the doctors are not too worried about running me at a slower rate for a couple of weeks until my fistula has gotten large enough to support larger needles and a faster flow.

I am receiving what is known as HEMODIALYSIS. This means that my blood is being filtered outside my body, much in the same way that the kidneys filter your blood inside your body. The blood comes out of my fistula and goes into the dialysis machine. The blood flows through a semi-permeable membrane (like the kidney) which helps clean impurities out of the blood. The chemical balance that your body requires is fixed, and excess fluid is removed from the body. Since my kidneys would normally remove excess fluid and any waste for me, and my kidney no longer does this successfully, I will have to have dialysis three times a week for four hours at a time until I receive a kidney transplant.

The good news is that I am finally starting to feel better. It seems like I have been sick all summer, and for the first time in a couple of months, I can go all day without feeling like I need to vomit. I am hoping that I will continue to feel better as the dialysis helps lower the overall toxin levels in my body and brings me back down to a more normal level. I'll have to let you know how dialysis goes on Tuesday.

I am Going to Start Dialysis

Well, I saw my nephrologist today. He said, based on how I am feeling and on my lab results, that I should go ahead and start on dialysis tomorrow. He has set up for me to be checked in to the hospital for about a week so that they can do inpatient dialysis and monitor me closely. I will probably do three or four days of dialysis this week, and then be released and scheduled for dialysis at an outpatient clinic.

I did receive the results of my Glofil test. It seems that my GFR is about 10 cc/min. That puts me well within range of the UNOS criteria for transplantation. So, after I get my new insurance on the 1st, then I am going to start the paperwork part of the process for getting a transplant. The doctor is very hopeful for me. He says that since I am young and my disease only affects my kidneys, I should be an excellent transplant candidate. He also expects that once I do receive a transplanted kidney, I should recover quickly and be able to live a long time with that transplant (as long as I continue to take care of myself).

So, my fistula is going to get tested out tomorrow morning, and all week, in the hospital. They will monitor me there to make sure there are no problems with my heart rate or my blood pressure. There are several possible things that can go wrong (as with any procedure), and they want to keep a close eye on me to make sure that I am okay.

My prayer requests are:

• That I would have good results from the dialysis next week
• That my fistula will work and I won't need a temporary dialysis catheter in my chest
• That I will start to feel better once my blood gets cleaned out

Released from the Hospital!

Well, as the heading proclaims, I've been released from the hospital. I am barely passing any blood from my kidney now, and they have gotten my hemoglobin count back above 9 (which is pretty low, but not too terrible). The hospital has given me some antibiotics to take for the next week just to make sure that there aren't any problems with my remaining kidney. They have also given me some anti-nausea medicine. My creatinine level is back above 6 again, and I am feeling nauseated on a regular basis.

Now that I am going home, I hope that I can go back to feeling better. I don't think we are going to try and push the exercise as much as we did before I got readmitted. I don't know if that made me feel worse, but I'd rather not take chances. I'll just have to get back up to taking walks every day.

I am supposed to get some more blood work done on Thursday, and I'll see my nephrologist on July 25 when he returns from vacation. I am also going to try and schedule a Glofil test for sometime next week. The Glofil test is a VERY accurate test of your kidney function. I took a Glofil test about two years ago and had a GFR (filtration rate) of 24 cc/min. The UNOS (United Network of Organ Sharing) will not allow anyone to be considered for a kidney transplant unless their GFR is below 20 cc/min. I imagine now that I only have one kidney that I will be able to meet this limitation.

In other news, my company is changing insurance companies on August 1. I had thought that this would be VERY bad news, but it turns out not to be too terrible. We looked through the network of doctors, and found that all of my doctors are available (which is great). Also, the prescription drug program is very comparable, as we will only be spending an extra $5 every three months per prescription. The only real negative is that my yearly out-of-pocket maximum gets reset, so the money that I've paid so far this year in medical expenses will not count after August.

One final thing: As of July 10, 2005, Jenny and I have been married for one year!! Now, I know that we were celebrating in the hospital, but it could have been worse. And, the way I see it, our second year of marriage cannot be too much more stressful than our first year. Marriage is great, and I really do love Jenny a lot!

Back in the Hospital

Well, it seems that my recovery wasn't going as well as I had hoped. I had some severe nausea today, and with it a LOT of pain in my right kidney. We went to the emergency room on July 5, and they decided to admit me to the hospital for a while to watch me. I have been passing blood from my kidney for about a week now, so I think they want to make sure that gets under control as well.

It seems that all that blood I've been losing has made me severely anemic. I am scheduled for a couple blood transfusions this week (while I'm sitting here in the hospital). They are just glad that my other kidney is showing no signs of infection, so they are not afriad they will have to remove it. The doctor did say, however, that if they need to take the kidney that they will do it to keep me alive.

The transfusions help with the anemia, and the doctors have told me to stop taking my blood thinner as it is causing more harm than good at this point. Since they never determined if a clot was responsible for my stroke earlier this year, it will be better to not risk the bleeding that I am having as a result of the blood thinner. They are also giving me an artificial hormone to help my body produce more red blood cells. This hormone is normally produced by the kidneys, but my body has not made enough of it for over a year. I've been taking an artificial hormone, off and on, for quite a while now and it seems to help.

Well, hopefully I won't be in the hospital too much longer. I want to get well so that I can go back to having a normal life. Please continue to keep Jenny and me in your prayers. Thanks!