Gastritis

I went to the GI doctor yesterday afternoon to have an endoscopy. The purpose of this test was to hopefully find out what is causing me to feel nauseated on a regular basis. The doctor put me to sleep, and slipped a scope down my throat to look at my esophagus, stomach, and upper intestines. She found a few things down there of interest.

First of all, she said that I have gastritis. WebMD defines gastritis as: “an inflammation, irritation or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic)”. She said that this might be the main problem, and told me to continue to take my Nexium. She took a biopsy and is sending it to the lab for more information. She also found a node at the bottom of my esophagus, and sent a biopsy of it off, as well. And, finally she said that I have a hiatal hernia. WebMD says a hiatal hernia is: “A hernia occurs when tissue from inside the abdomen bulges out through a weak spot in the muscles of the abdominal wall. When part of the stomach bulges upward out of the abdomen and into the chest cavity, it is called a hiatal hernia”. It seems that lots of people have this type of hernia and never know it because they never are looked at. She said that it is not causing any problems and probably will not cause any in the future. So, in conclusion, I get to add gastritis to my list of infirmities (yippee).

I have dialysis scheduled again tonight. I did not bring any emla cream with me today. I want to see how the treatment goes without it. I am not a big medication fan, so if I can do without it, I think I might just skip it. Saturday, my fistula started to hurt, so the technician stopped the machine and moved one of the needles around. She got to it pretty quickly, so I did not have any bruising. It is always important to complain when there are problems. I just have to remember that next time. I should get my chest catheter flushed today. They said that they are only going to look at it once a week now that they aren’t using it. I hope that it will soon be removed.

I sent my cardiologist a list of my blood pressure for the last two weeks. She had upped the dosage on one of my medications, hoping to lower my pressure. That did help some, but not enough. So, she is adding a third medication to my hypertension list. I am now taking 5 mg of Norvasc every day (at least for the next two weeks). I am supposed to show her my pressures again and then we will see where to go from there.

Finally, I got a call Monday afternoon from the pre-transplant coordinator. I am officially on the kidney transplant list for the next year! It seems that I passed all of my tests, and that I am on the list. I guess the insurance company re-evaluates you on a yearly basis, so you basically have to have your status as someone that needs a kidney renewed every year.

Being on the transplant list is great news! I have the packets of information, and I just have to go to the Post Office to mail them out. You should be getting them (and a cheesy DVD) in the next week or so if you volunteered to get tested.

Thanks for coming by to read!

Finally Back to the Fistula

I had dialysis Tuesday night. The doctor had said last Thursday that he wanted to start using my fistula again (at least with one needle). So, I got to do my dialysis with the blood being drawn from my arm and put back into my chest (via the catheter). The doctor came by and he said that everything looked good. He wants to use two needles on Thursday (and no catheter!). He will have them do that for a week or two and then if everything is okay, they can schedule to have the catheter removed. I am really looking forward to having it taken out.

I used the emla cream on my arm last night to deaden the needle site. It works just like it says. The pain was very little, and I think I will probably continue to use this cream for a while. Even though I only had one needle, and it was small, I think that the cream will be much nicer than just bearing with the pain each week. I guess that since it was a small needle, my arm healed much better than it used to.

I have been having a few problems recently. There is still blood in my urine (since Sunday morning), but there is not any pain with it. The nurse at dialysis said that if it continues, then they will need to check my hemoglobin levels to make sure I am not losing too much blood. But, my polycystic kidneys can cause bleeding, so they are not too worried yet. I won’t be worried unless it lasts for a while or if it starts to cause a lot of pain.

I went and saw a doctor of gastroenterology yesterday. I am hoping that she will be able to help me with my morning nausea that I’ve been having since this summer. She took my medical history and set up a few tests. She wanted some blood work (which I was able to get at dialysis last night). She also wanted an ultrasound of my liver and gall bladder (which I got this morning while having my kidney and abdomen scanned for the transplant evaluation). She also wants me to have an endoscopy, which is where a camera takes a look at your esophagus, stomach, and upper intestines. I have that appointment scheduled for Monday. It should be a lot of fun. I get to take a little nap. I still have to find a ride home, but I’m working on that. I have a few people that I can call.

I had an appointment with my family doctor today. The GI doctor had noticed some white pus in my throat, and she wanted me to get tested for strep. The doctor ran a swab today and it was negative for strep type A. She has to send it off to the lab to be run to see if I have anything else that could be causing my problem. She prescribed me some antibiotics to take for the next 10 days, so if it is bacterial, then that should clear it up. I also asked her for the name of some genetic counselors that Jenny and I can talk to before we decide what to do about having children. I already know that I have polycystic kidney disease (which is autosomal dominant), and the cardiologist that I saw for my transplant evaluation wants me to get tested for Marfans. (I have an eye doctor appointment this afternoon, I will ask him to take a look at my eyes and see, and apparently there are some signs of Marfans that show up in the eyes).

So, that’s it for now. I should be done with my chest catheter in the next couple of weeks. I will be taking antibiotics for the next ten days to clear up my throat. And, I think I am closing in on the finish of my transplant testing. Thanks for reading.

Monday, January 23, 2006

Well, it’s Monday and I am here writing a nice quick blog update. I received an underwhelming response to my request for more subscribers, but that is okay. Perhaps everyone has decided to do an RSS feed, or to just actually come by the website on a daily basis (who knows?). I did stop by the template to add a couple of links on the side. I have some friends that are trying out blogging, so I figured that I could give them a link.

Let’s see … what does everyone want to know about? My transplant testing seems to be going okay. I spoke with the pre-transplant coordinator this morning, and she said that the only thing she needs (for now) is an abdominal sonogram. She is going to hunt through my records to see if there is a recent one available, and if not, then she will have me go and take another one (they aren’t painful, so it’s not a problem). I have the donor application forms at home, and I think I have all of the addresses. I just need to get some envelopes at Wal-Mart on the way home so that I can send them out. I am hoping to do that today, so you should see a Donor Application in the mail this week (if you’ve expressed an interest).

I’m fairly healthy, considering what all is wrong with me. The nephrologist at dialysis said that he wants to start using my fistula FOR SURE on Tuesday. It is in my orders and the technicians know it, so they will use one needle in my arm and one tube in my chest. I do not know how long they will do that, but hopefully it will go quickly back to all fistula and no chest soon. I want to get these tubes out of me! The doctor also recommended self-cannulation, which I am going to research. For this, it probably means that I will send an e-mail to Jonathan Finger and ask him how his self-cannulation is going. He’s the only person that I know that is doing it, so he is a good resource.

Otherwise, there’s not too much going on. I woke up around midnight Saturday/Sunday with pain in my back near my remaining kidney. I took some medication and was able to go back to sleep. Of course, since then, I have been passing blood in my urine, which is not a good thing. I’ll have to let the doctor know that this week when I see him.

Jenny’s birthday went well. I decided to get her a Baylor hat (which she had suggested) and a pot of tulips (which are her favorite flowers). We also went out to dinner on her birthday and had a great time. Thank you all for your suggestions. I will keep in mind the couples day-spa experience for after I get my chest catheter removed.

Thanks for coming by to read!

Time for an Update

It has been a while since I have written anything, so I figured that it was time for me to update everyone on what is going on. Last time, I gave everyone my January lab report that I got from dialysis. And of course, previously, I had mentioned that I started my transplant evaluation two Mondays ago. They have drawn a total of 22 vials of blood (so far) in my evaluation, and I am sure that there is more to come.

I went to see my cardiologist on Monday afternoon. My blood pressure has been quite high at dialysis since I was taken off of the Norvasc and put on the Toprol XL. Now, my heart rate was fixed by the Toprol XL, so I am grateful for that. But, I need my blood pressure to be lower so that I do not have a stroke or a heart attack. So, the cardiologist upped my dosage of Diovan from 160 mg / day to 320 mg / day. The Diovan has not had a chance to get into my system (at the higher level) yet, so I cannot report how well it is working. I am supposed to track my blood pressure for two weeks and then let the cardiologist know. If it is going well, then I am okay. If not, then it is time for more medications for me!

I have the “Living Donor Transplant Applications” sitting here on my desk. I am going to be looking for addresses to send them out to those of you who have asked if you could be tested for giving me one of your kidneys (thank you!!). I also have a DVD from the transplant people, which I may or may not be able to send out copies of. Be looking in your mail (or maybe e-mail, if I can convert them to an electronic format) in the next week, and be sure to send them back as FAST as possible.

Let’s see … in other news, I will start using my fistula again on Thursday. I have not used it in about seven weeks, which should be long enough for it to heal. The dialysis clinic said that they will use the small (17 gauge) needles so that there won’t be too much stress placed on the vein. I do not know if they will use one needle or two; I guess it just depends on what the doctor indicated in the chart (since he mentioned both at different times). I have not seen the doctor this week, so he should be there Thursday and be happy to see my fistula in use again.

I have been having stomach ache problems again lately. I thought that the Nexium had helped, but I seem to be having problems again. I am waking up not feeling well several days a week, which is certainly no fun. So, I have an appointment with a GI doctor next week, and hopefully she can find out what is wrong with me and offer some helpful solutions.

Please pray that my transplant evaluation will continue to go well and that they will find everything that they need. Also pray that I will not have to live with my stomach problems for much longer. It is all in God’s hands at this point.

Some of you are receiving this post by e-mail today and have no idea why. I had a few people in the orchestra and in my old ABF class mention that they would like to know how I am doing. So, for today only, I am sending a copy of this post out to those two group lists. If you would like to receive all of my updates via e-mail, then please REPLY to me and let me know. I can subscribe you to all of the new posts. Or, if you would like to just read these posts on the web, then go to http://nmccart.blogspot.com/. You can also subscribe to the ATOM feed at http://nmccart.blogspot.com/atom.xml.

January Labs

I got my lab report for January back on Tuesday evening. Everything is looking great. All of my major numbers (the ones that the dietician worries about) are right in the middle of their ranges. This means that I am doing everything that I can to keep myself healthy at this point. All I have to do is to keep taking my phosphorus binders (that seems to be the hardest thing for me to remember).

I went with the long listing for my lab results again this month. That seemed to work rather well in December, and it was fairly readable for most. The test is in ALL CAPS. My results are after the semi-colon (:). If my results were high or low, I noted that between two asterisks. The measurement is after the dash, and the reference range is in parenthesis after the measurement definition.

• WBC: 6.21 – 1000/mcL (4.80 – 10.80)


• RBC: *LO* 4.23 – mill/mcL (4.70 – 6.10)


• HGB: 14.0 – g/dL (14.0 – 18.0)


• HCT: *LO* 41.0 - % (42.0 – 52.0)


• MCV: *HI* 97 – mcm3 (80 – 94)


• MCH: *HI* 33.1 – pg/cell (27.0 – 31.0)


• MCHC: 34.1 – g/dL (33.0 – 37.0)


• HGB X 3: 42.0 - % (42.0 – 54.0)


• Platelets: 181 – mg/dL (6 – 19)


• Pre-dialysis BUN: *HI* 32– mg/dL (6 – 19)


• Pre-dialysis CREATININE: *HI* 7.3 – mg/dL (0.5 – 1.2)


• POTASSIUM: 4.5 – mEq/L (3.3 – 5.1)


• BICARBONATE: 25 – mEq/L (22 – 29)


• ALKALINE PHOS: 81 – U/L (40 – 129)


• AST/GOT: 30 – U/L (13 – 39)


• TOTAL PROTEIN: 7.0 – g/dL (5.9 – 8.4)


• ALBUMIN (BCG): 4.6 – g/dL (3.8 – 5.2)


• CALCIUM: 9.5 – mg/dL (8.4 – 10.2)


• PHOSPHORUS: 4.4 – mg/dL (2.6 – 4.5)


• Ca X P PRODUCT: 42 – (<55)


• SODIUM: 141 – mEq/L (133 – 145)


• CHLORIDE: 103 – mEq/L (96 – 108)


• CHOLESTEROL: 93 – mg/dL (<200)


• TRIGLYCERIDE: 185 – mg/dL (<200)


• IRON: 66 – mcg/dL (45 – 160)


• UIBC: 212 – mcg/dL (110 – 370)


• TIBC (CALC): 278 – mcg/dL (228 – 428)


• TRANSFERRIN SAT. (CALC): 24 - % (20 – 55)


• FERRITIN: *HI* 641 – ng/mL (22 – 322)


• Post-Dialysis BUN: 8 – mg/dL (6 – 19)


• UREA REDUCTION RATIO: 75 - % (65 – 80)


• Hemoglobin A1C: *LO* 4.4 - % (4.5 – 5.7)


• HBsAg: Negative (Negative)


• HBsAb: <10 – mIU/ML (<10 mIU/ML – NON-IMMUNE)


• HEPATITIS C (ANTI-HCV): Negative – (Negative)


• ALUMINUM UNSTIM: <5 – mcg/L (0 – 10)


• BIO-INTACT PTH (1–84): *HI* 134.3 – pg/mL (12.6 – 53.5)


• TSH: <0.01 – mIU/L (0.35 – 5.50)


• HDL: 31 – mg/dL (Male <35 suggestive of increased susceptibility to Coronary Artery Disease)


• CORRECTED CALCIUM: 9.0 – mg/dL


• CORRECTED Ca X P PRODUCT: 40

So, as you may or may not be able to tell, I am doing quite well. My hemoglobin was a normal number, so that did not have to give me a hormone injection last week. My pre-dialysis BUN and Creatinine are up a little from last month, which may have something to do with me feeling sick more recently. My potassium is up higher in the normal range, but still not high enough to get off of the 3K solution at dialysis. My phosphorus is finally down into the normal range, which is wonderful. It means I have been taking my binders enough to stay healthy. My calcium is also up a little bit (which is related). My post-dialysis BUN was the same as last month, but my Urea Reduction Ratio went up 3%. I am guessing that is due to using the chest catheter instead of the neck catheter that was not working very well.

So, I have another dialysis treatment scheduled for tonight. It should be lots of fun. The nephrologist was not there Tuesday, so I expect to see him tonight. He will probably ask (again) why I am not using my fistula, but I will tell him that I am waiting until the 19th. I may also ask him for some emla cream to deaden my arm before I start back on the needles. The emla cream (name supplied by a dialysis nurse friend of mine) is a local deadener that is placed on the skin about an hour before your treatment to try and prevent the needles from hurting so much.

I have an echocardiogram scheduled for tomorrow morning. This is for my transplant workup so that they can see just how well my heart is working. I also have an appointment with my cardiologist on Monday. I am going to show her my high blood pressures for the last month and hope that she can prescribe me some new/different blood pressure medication. I don’t want to have any extra problems that could be fixed. I have more labs set for Monday morning, though I don’t know why they would need any more of my blood. I also get to meet with the transplant doctors, so that should be nice.

Thanks for reading. You’ll know more when I do.

Started Testing

I started my transplant evaluation yesterday. I drove down to the Dallas Transplant Institute at 11:00 am to begin the process. I had a chest x-ray taken, and then they took 21 vials of blood. That’s right, TWENTY-ONE VIALS of my blood. If I had known that they were going to take that much, I’d have brought a box of cookies to eat. But, it wasn’t that bad, and the tech found a vein that gave her all of the blood with no problems. I also spoke with a social worker that made sure I understood everything that was to come in the world of transplant. Then, I saw a nephrologist and he talked about everything that he knew.

The nephrologist seemed pleased that I have several potential donors. He said that the larger the pool of potential live donors, the better chance I have of finding a compatible kidney. He also said that sometimes people get matched by a cadaver while their donors are being tested, and then you have to decide what to do. He said the best thing was probably to take the cadaver kidney and save your donor in case your graft fails later on.

I’ve got more testing on Friday and Monday, but it shouldn’t be too bad. I think that the 21 vials of blood was the only invasive procedure currently scheduled. I also am supposed to see my cardiologist on Monday. My blood pressure has been high since the beginning of December, and I think I need some new medication (or new dosage). Hopefully she will be able to suggest something. I should also see the nephrologist at dialysis tonight. I imagine that he will say I should be using my fistula. I’ll tell him that I’m waiting until the 19th.

Thank you everyone so far for the suggestions for presents for Jenny. I have received several good ones, and one bad one. So, Vizinni, I refuse to buy iocaine powder. I know that it is odorless, tasteless, and dissolves instantly in any liquid, but I have yet to develop a tolerance, so I don’t think it’s a good idea. I was also given the idea of a couples spa weekend. That sounds like a good idea, but I think I will wait until I do not have a catheter in my chest and I am allowed to get wet again.

So, keep sending those suggestions and keep praying for a quick transplant evaluation. Thank you all for praying and reading.

No Fistula Thursday

Well, as it turns out, I did not have my fistula used on Thursday night. I guess that the nephrologist did not put an order in my file for me to go back to using the fistula, so the nurse just hooked me up to my chest catheter again. Now, I am not one to complain about not being injured, so I did not mention anything. I was a bit hesitant about going back to the fistula before the vascular surgeon had recommended. According to him, I should wait until January 19 to start using my newly healed fistula. That is still six dialysis treatments away, so I will see how long it takes for the nephrologist to write down his order. If he never does, then I will suggest using the fistula starting January 19.

My arm is a bumpy, knobby sight. I think I might have disgusted a couple of people at lunch yesterday by rolling up my sleeves. I had shaved the hair around my fistula yesterday in preparation for dialysis, and so now the curves and throbs of my vein are easily visible on my arm. Normally, my arm hair covers this up, but no longer. I was tired of having that hair removed forcible by tape, so I shaved it off myself. I guess I will let it grow for a couple of weeks again until the clinic is ready to use my arm.

Let’s see … in other news, my wife’s birthday is one week away. She said that this year, I should try and get her something better than last year’s present. What did I get for her last year (you may ask)? I got NOTHING. That’s right, a big old box of air. A sack of emptiness. A handful of invisible goodness. This is where I come to you, the loyal readers (especially those that don’t mind sentence fragments in the interest of a good story). I have an e-mail link at the bottom of my page. Or, you can write comments on the page itself. Toss out some ideas for a good birthday present. She’s going to be one year older and more beautiful, so I am sure that anything you suggest will be my choice from 2004. Let’s hear it, world!

Thank you for coming by to read, today. I look forward to sorting through the list of gift ideas and seeing what eBay and my bank account REALLY think of them. I am continuing to enjoy the horrid tubes in my chest, which will hopefully be gone by February (maybe). Enjoy your day!

Back to the Fistula

Dialysis went well on Tuesday. I saw the nephrologist, and he wanted to take a look at my fistula. Now, the nephrologist comes by about once a week, and sees all thirty patients in about thirty minutes. I know that this doesn’t seem like long enough for him to actually say anything to you or actually do anything, but I think he must have taken lessons from Santa Claus. He delivers himself to all of the good little dialysis patients.

Sorry for the tangent. The doctor asked me if I was using a catheter in my chest because they had infiltrated my fistula and were waiting on it to heal. I had my fistula revision surgery on November 28 (which was five weeks and one day before Tuesday). I reminded the doctor that I had, in fact, had a fistula revision (at his request) in order to get a better dialysis treatment. He felt all over my arm, like a prospector looking for gold, and announced that I need to go ahead and start using my fistula again. So, even though the surgeon (who put in the fistula and did the revision) said that I should wait until January 19 to begin using the fistula, my nephrologist wants me to start up again on January 5 (which is today). I have warily accepted my fate. I think I would prefer to get the best possible dialysis treatment, but I have enjoyed not being stuck with harpoons three times a week.

So, I head to dialysis tonight, ready to have my arm stuck again. I shaved a ton of hair off of my arm, in preparation for the hair-removing tape that they seem to be fond of at the clinic. I am also considering asking the nephrologist (next week) if he can write me a prescription for the lidocaine cream that one of the other dialysis patients recommended. He said that all you have to do is to rub it on the needle sites before your treatment, and they will temporarily numb them so that the needles won’t hurt as much. He said that it is way cheaper than having the lidocaine shots, and it can’t hurt as much (since there are no needles involved). The guy that recommended them said that a one-month supply usually lasts him five or six months, so the cost shouldn’t be too bad.

I will still have to change into my button-down flannel shirt at dialysis for a while. They will still have to have access to my chest catheter to flush the lines and clean the site where the tubes go in. I imagine that if my fistula is working after a week or two, then they will probably have the catheter removed. Then, it will be back to enjoying showers the way everyone else does (ah, the good old days).

I am thankful that my dialysis does not treat me badly. There is a woman that sits near me at the clinic that has been having problem. I cannot tell if she is REALLY bad off, or if she just likes attention. She had some serious problems with her catheter last week, to the point where they were using her catheter and fistula both just to treat her. She was freezing cold most of her treatment, which seemed terrible. I’m just glad that I’m normally not that bad off during the treatment, though I started to cramp just a little bit on Tuesday. If I cramp badly, then it will be time to up my dry weight again.

Thanks for coming by to read. Have a great day!