Friday, April 28, 2006

April 2006 Lab Reports and More

As promised on Tuesday, I am bringing the rest of my long-overdue update. I apologize for the wait, but I have been quite busy at work and at home, so I haven’t had a lot of time for blogging recently. I will try to be better about it in the future (isn’t that what they all say?).

  • ALBUMIN: 4.3 (goal is 3.8 to 4.5)My albumin (blood protein) is normal.

  • POTASSIUM: 4.3 (goal is 3.5 to 6)My potassium level is normal. I am doing a good job with the potassium in my diet.

  • CORRECTED CALCIUM: 8.7 (Goal is 8.4 to 9.5)My corrected calcium is normal.

  • PHOSPHORUS: 6.6 (Goal is 3.5 to 5.5)My phosphorus is high (up from 4.3 last month). The dietician recommended that I watch my diet and make sure to take my phosphorus binders with all meals and snacks.

  • HEMOGLOBIN: 11.2 (Goal is 11 to 12)My hemoglobin is normal, and my anemia is under control.

  • AVERAGE FLUID WEIGHT GAIN: 2.31 kg or 3.3% (goal is 3 – 5 % of dry weight unless you have sign and symptoms of fluid overload).This is Acceptable.

  • HEMOGLOBIN A1C: 4.9 (Goal is less than 7.5) My hemoglobin A1C is well-controlled. This means that my average glucose (blood sugar) has been normal for the last three months.

  • PTH: 415.6 (Goal is 100 – 300)The parathyroid hormone is too active. This means that I started receiving Hecetor (Vitamin D) during dialysis.

So, the lab report was not all good news like it normally is. My phosphorus was way up, which is not a good thing. Too much phosphorus can make your bones brittle. The other problem was the parathyroid hormone, which I have no control over. Hopefully the Vitamin D that they inject into my blood each week will help balance that number out. The only negative side effect is that it can cause your phosphorus to go up. I guess I’ll find out in May how I did with my diet and see if I can get off of that Vitamin D shot.

On Monday, April 24, I went to see the endocrinologist. I actually just saw a nurse practitioner who wrote me three prescriptions for blood work to be drawn at dialysis. They want to see my thyroid hormone levels in April, June, and July, and then to follow-up with me after that. She said that since I have not been exhibiting any symptoms, that I am probably doing okay, but she needs to see the lab reports to make sure.

On Tuesday, April 25, I went to see my vascular surgeon to follow-up, one month later, on my new fistula surgery. He removed all the stitches (not so pleasant) and then ran an ultrasound over the fistula. He said that it looks like it is healing nicely and is developing at a good rate. He scheduled another appointment for one month later, and said not to use the fistula before then. I guess he will check it at the end of May to see if it is ready for dialysis. If so, then I can get off of the chest catheter, and I can go back to using a fistula like a normal dialysis patient. The fistula is a little easier to care for, and gives you a better treatment, so I ultimately want to get back to using a fistula.

I have had dialysis on Tuesday and Thursday this week already. The treatments have been going fine, right up until the very end. After I have finished my treatment and have been removed from the machine, they like to take one final blood pressure with you standing up. On Tuesday night, the pressure was only 93/61, and they wait about fifteen minutes for me to get up to 110/69. Thursday night, my pressure was 94/58, and they waited about ten minutes to get me up to 113/60. My standing blood pressure (at the end of dialysis) has been low since Tuesday, the 18th. I wish this would balance out so I could go home when dialysis is finished.

My gastroenterologist called this week. She thinks that my stomach-ache problems might be caused by my gall bladder. There is a test that can be run (inject a dye and watch it go) that will tell her if the gall bladder is the culprit responsible for my pain. I have this appointment scheduled for Monday.

Here are my prayer requests for today:
  • Pray that the gall bladder scan goes well, and that the GI doctor will learn what she needs to learn to help me

  • Pray that my blood pressure will get to where it needs to be at the end of my dialysis treatments

  • Pray for my dad as he is being scheduled for testing as a kidney donor.

Thanks for coming by to read. I’ll try to be better about updating next week.

1 comment:

Jonathan Finger said...

Yo Nathan,
Sorry to hear your labs weren't great this month, though in all honesty, they're not too bad! :) I wish I had your labs most months.

6.6 for phos is a bit high, but not way high. Your high phosphorous and high PTH (parathyroid hormone) are most likely in cahoots with each other.
As the activated Vit. D helps reign in your high PTH level, your phosphorous level will be easier (not harder) to get in line.

I've been fighting to keep the balance of these two in check for the last four years, and still haven't found a good way to do it!
It seems that every time I get my phorphorous to an acceptable level, I lax in my binder intake, and then up it goes. As it goes up, so does my PTH - the two go hand in hand.
Your parathyroid kicks out PTH in order to pull calcium from other parts of the body (bones) to balance with the phosphorous - you mentioned this in your post. So having your phos jump a bit can cause your PTH to rise - getting the PTH in check will help enable you to lower your phos with more binders, etc.

Ok, I'm repeating myself now ... :)

Anyway, sorry to hear that you're having GI issues and possible cardiac issues.
I will continue to pray for your health, and wish you the best with finding a living donor.

You're on the UNOS list right?