A Positive Blood

I talked to my transplant coordinator earlier this week. She said that my status is back on (since I was placed on hold after having my gall bladder removed). I also asked her to verify my blood type, and she said that I am A POSITIVE.

I sent an e-mail to the remaining three potential donors in the Dallas area that had already had their blood work completed. I asked them to contact the transplant coordinator to set up testing appointments. I am hoping that she will be able to set up testing for all three of them so that we can find a match more quickly, but who knows. She may still want to do them one at a time.

I did not have a great treatment on Saturday. The machine ran slowly, and the charge nurse came by and told me I should consider moving up to the 15 gauge needles. I told her I would think about it. I went home at my dry weight (70.5 kg), but did not feel good with a very low blood pressure and a slight temperature. I stayed up for about two or three hours after my treatment waiting on my temp and pressure to even out. We ended up going to bed late, but at least we did not have to take a trip to the emergency room.

Tuesday, I did go ahead and use the 15-gauge needles. I have been using the 17-gauge needles for almost three weeks. I was hoping my fistula would behave before moving up, but the machine does not seem to like the smaller needles with my vein. The 15-gauge treatment went well. I had them only take me down to 71.0 kg, so I think that helped me feel better. I have also stopped taking one of my blood pressure medications to see if I can get my blood pressure to even out a bit. I guess I will find out at tonight’s treatment.

So, I am on 15-gauge needles now, which is good. The machine ran at 350 ml/min on Tuesday, and I think they are going to try the full 400 ml/min today. 400 is the rate that they prefer to go. I think the machine can run faster, but they don’t normally do that.

I have to ask for my thyroid function test results today so that I can send them to my endocrinologist. I have an appointment with him on Monday, and I’d like it to be the last one I have. I think my function has leveled out (according to my results) so I should not need to see him anymore.

Please pray for the potential kidney donors. Pray that their tests will be scheduled easily and that they right person will be found to be a donor. Thanks for coming by!

After My Vacation

Hello everyone. I realize that my last post was eight days ago, but I have not been around much. Last weekend, Jenny and I took a short trip to Arlington to celebrate our 2nd wedding anniversary. We had a good time, but I did not do any computing while we were gone, so I am a little behind on my blog. I have several updates to make, and hopefully I will not forget any of them.

I went to the nephrologist’s office after work on Friday, July 14. He took out the chest catheter and bandaged me up. This catheter had been in since March 24 (almost four months). They used it off and on, and even cleaned it out once. I am glad to be finally rid of it. I can now take showers (like a normal person) and sleep on my stomach again.

Like I said, we went out of town over the weekend. I had a dialysis treatment on Saturday, which wasn’t all that bad. The technician that I got on Tuesday was new (to me). Since I have not had a lot of success recently with my needle sticks, I figured it would be okay to let someone different have a shot at my arm and see if maybe she was better at sticking me. She was not. She had to go and get another technician to stick the arterial side of my access. I don’t think it was her problem. I have determined that there is only really one or two technicians that can consistently find my arterial access.

Saturday’s treatment had lots of struggles. So did Tuesday this week. I got a decent stick, but the machine didn’t seem to like it. According to the technicians, there is not quite enough stickable area on the fistula. They have to stay one inch away from the surgical site (on both ends) and try to keep the needles from being too close together. This is difficult, as the entire fistula is only about 4 or 5 inches long. It is also slightly curved, which leaves less spots in which to insert the needles. Fortunately, someone has been able to find a spot to go in each treatment so that I can be dialyzed.

Thursday’s treatment went fairly well. I got a quick, easy stick, and the machine ran at 300 ml/min for most of the treatment (and at 290 ml/min the rest of the time). My thought is that if I can get six good treatments in a row (no machine problems, and little to no sticking problems) that I will move from 17- to 16-gauge needles. The larger needles give a better treatment, but I do not want to try and use something larger until I can get the little needles to work properly.

In other news, I have been working with the financial department at Baylor to figure out who is going to pay for my father’s transplant evaluation. It turns out that the paperwork was initially misfiled, but that the current balance is $0. This is good news, and it means that I can contact my other donors and get them started. So, if you see my name pop up on your caller ID, then it’s time. I haven’t decided if I am going to do one donor, or have all three of the people that live in town and completed their paperwork to go at the same time. I might try that, just to confuse everyone. It should be fun.

Aside from that, I have nothing too interesting to report. I have an appointment with the endocrinologist on July 31. I don’t think I will have to go back to see him after that. My TSH levels have been normal for nearly a year now, so I think my thyroid problems have subsided. It would be nice to have one less doctor to keep up with. Maybe I should try and schedule a neurology appointment and get rid of her, as well. I haven’t had any stroke problems in over a year, and maybe she can reduce some of the medications she prescribed. I’ll have to get on that one.

I have a few prayer requests for you to consider:

• Pray that the technician at dialysis will get a good stick that works well for the next several treatments(by works well, I want the machine to run at 300 ml/min and to not have arterial alarms caused by being unable to pull my blood)


• Pray that we will find the right person with the right kidney at the right time to be a donor for me

I am currently searching my records to find out what my blood type is. When I get it, I will let you know. I have had many people as me about this, and I wanted to be able to give the right answer.

Monthly Labs - July 2006

It is time, once again, for Nathan's Monthly Lab report. Yes, that's right folks, about this time every month, I get a copy of my lab reports from the dialysis clinic and I share them with you. So, sit back and relax, the fun is about to begin.

• Albumin - 4.7 (Goal is 3.8 to 4.5)
• enPCR - no recent value available
• eKdrt/V - no recent value available
• Potassium - 3.9 (Goal is 3.5 to 6.0)
  Your potassium leve is normal.
  You are doing a good job with the potassium in your diet.
• Corrected Calcium - 10.0 (Goal is 8.4 to 9.5)
  Your corrected calcium is high
  Check with your doctor
• Glucose - no recent value available
• Phosphorus - 3.3 (Goal is 3.5 to 5.5)
  Your phosphorus is low
  Your dietician will discuss your food choices
• Cholesterol - no recent value available
• Hemoglobin A1C - 5.2 (Goal is less than 7.5)
  Your hemoglobin A1C is well controlled
  This means that your average glucose (blood sugar) has been normal for the last 3 months. Good job!
• Hemoglobin - 11.0 (Goal is 11.0 to 12.0)
  You hemoglobin is normal
  Your anemia is under control
• Average Fluid Weight Gain - 2.02 kg or 2.9% (Goal is 3-5% of dry weight unless you have signs and symptoms of fluid overload).
  This is acceptable.

So, this month's report was filled with good news. For one, my Phosphorus went down from 7.5 in May, to 5.4 in June, to 3.3 in July. The dietitian said that I should adjust my phosphorus binders to try and get my number back up into the normal range. I'll see if I can figure out just the right amount to take to keep myself healthy. Taking a little bit less of the phosphorus binder will also help my calcium get back into the normal range (since the binders are basically calcium pills). As you can see, everything else is looking normal. My dry weight is 70.5 kg, at the moment, and I am thinking about having it raised to 71.0. I've had some dizziness and cramping the day after my treatment, and I think it might be fluid related.

I finally saw the nephrologist on Tuesday. I got myself scheduled for a Friday afternoon appointment to have the temp-cath in my chest removed. I will be glad to finally have those tubes out. Then I don't have to worry about it getting infected. I think the doctor had me confused with someone else when he talked to me. He asked how some other problems that I had never had were going, and I told him they were okay. I guess that's the problem with having one doctor cover 30 patients in one hour.

I talked to the insurance company this week, and they said that I needed to talk to the financial department at Baylor. I sent them my billing statement and the letter from the insurance company notifying me of payment rejection. The financial department is supposed to look over everything and see if they can figure out who is supposed to pay them. Plesae pray that this gets figured out quickly so that I can have more potential donors tested soon.

I have received many encouraging comments on the blog and direct e-mails. Thank you all for your prayers and your support. Keep posting comments and sending e-mails. I don't reply to each and every one, but they all give me a boost each time I read them.

Back from Arkansas

Hi, everybody. I am back from my trip to Arkansas, and I thought I’d share some stories with you. I traveled to Fort Smith, Arkansas, last Friday night for my 10-year high school reunion. I called the Fort Smith dialysis clinic, seeking a spot for possibly Saturday morning. I was told that they had no open chairs in any shift all weekend. So, I called Poteau, Oklahoma, and they opened up a spot for me on Friday night. I went to the clinic, and was the only one there. They nice people in Poteau opened up their clinic just for me so that I would be able to attend my reunion.

My treatment went fairly well. They Poteau clinic did things a little differently. First, they measured your weight in pounds instead of kilograms. That meant they had to convert your difference to kilograms to input into the machine (which seemed odd, since their scale worked in kilograms). I just took my kg weight and subtracted my dry weight for a good UF removal. The other difference in treatments was how they administer heparin. At my clinic, I get 6700 units at the beginning of my treatment. In Poteau, they like to give some at the beginning, and then a little more during the treatment later on. Unfortunately, they didn’t give enough on the later shots, so my blood ended up clotting in the machine with 10 minutes left on my treatment. They returned as much as they could, but I ended up being a half kilo under weight (due to unreturned blood). That left me a little light-headed, but overall, it was a good treatment.

I was really happy that the clinic opened up for me. They didn’t have any other patients and did not have to stay open, but they did. They also told me that the Fort Smith clinic almost never opens up a seat for travelers. I think I’ll have to call one of the nephrologists in Fort Smith the next time I go back to see if they can get me a spot. So, Jenny and I went to the reunion activities on Saturday and had a pretty good time. I saw several people that I had not talked to in 10 years, and we had some e-mail exchanges, so I should be able to keep in touch with them at least for a while.

On Sunday, we went to church with my mom. I was able to talk to many, many people that have been praying for me. It was really heartening to see all these people that have been praying for God to help me be healthy again. I am thankful for such a wide group of people that lift me up. Thank you to anyone that has been praying for me.

I think I probably will have put on a lot of fluid weight over the weekend (since I will go four days between treatments instead of two). I suppose I will have the clinic take off 3500 ml per treatment until I get back down to my dry weight. The bonus of that is that I will not get dehydrated during dialysis this week!

The nephrologist did not come to the clinic last week. I need to ask him this week to write an order to remove my catheter. They haven’t used it in several weeks, and it is an easy way to get an infection, so I want it removed. The doctor has to order it, but I hope he can do it soon. I also have to get my TSH blood work results back so that I can send them to the endocrinologist. They are checking my TSH levels to make sure my thyroid is working normally again (as it is supposed to). I just have to get the results and send them to the endocrinologist, since the dialysis clinic can’t seem to do that.

Please pray this week that my treatments will all go well and that I won’t end up at the hospital. Pray that the doctor is able to get me in to have my catheter removed soon. And, pray that I can talk to the insurance company and figure out the payments for transplant testing.

By the way, today is my 2nd wedding anniversary! Thanks for reading.

Home for the Weekend

Today is Friday, July 07, 2006. Let me tell you about my dialysis treatment last night. I went in to dialysis, hoping for a normal treatment. I weighed in, and got into my seat. The needles were placed in the normal up/down fashion (as they should be) and I was set to go. The machine ran at 270 ml / min (remember that 300 is good for this size of needle). My treatment went great, and when it was time to go, I only weighed 70.0 kg. My dry weight is supposed to be 70.5 kg at this time. Now, a half of a kilogram may not sound like anything to you (in fact, it probably doesn’t sound like anything, it’s a little over a pound), but in terms of your body’s fluid level, it is kind of a lot. Basically, they dehydrated me.

I went home, and was okay for about 30 minutes. But, about 9:45, I began to feel nauseated. I had uncontrolled vomiting for the next two hours, so we decided to go to the emergency room. Sadly, uncontrolled vomiting is not that bad of an ailment, so we sat in the waiting room for an hour. I think by that time I had gotten rid of EVERYTHING from my stomach, so I did not throw up any more. When we went back, the doctor gave me some Zofran for my nausea, and then hooked me up to a bag of saline to get me re-hydrated. I slept for about an hour, and then they gave me one more shot of Zofran and sent me home. I did not go in to work this morning, because I needed the sleep.

Today, Jenny and I are traveling to Fort Smith for my 10-year high school reunion. On the way, we are going to stop in Poteau, OK, for my dialysis treatment tonight. I normally dialyze on Saturday nights, but I could not find a clinic in the area that would treat me Saturday night. So, I am going to experience “traveling dialysis.” I don’t know if this is a good thing, or a bad thing, but I am going to try it out.

Please pray for me that this treatment will go well. Pray that we have safe travel to and from my reunion. And, pray that I get to feel better as the weekend goes on so that I can enjoy seeing my old classmates.

Thanks for coming by!

Monday All Over Again

It has been another week since I have updated my blog. A bit has happened, so I’ll see if I can remember everything to fill you in.

The technicians at dialysis continue to use my fistula. Thursday, I had a different tech. He stuck in one needle up and one down, and the machine ran at 310 for four hours. That was a pretty good treatment. I asked the next tech I had (on Saturday) to sick up and down as well, and she was able to get the needles in. The machine didn’t run quite as fast, but I don’t think she hit the fistula quite as well.

I am planning on going to my high school reunion this weekend. It has been 10 years since graduation, and I’d like to head back. So, I am going to try out “traveling dialysis”. I’ve scheduled an away appointment for Friday night in Oklahoma (on the way back home). Hopefully everything will go well and I won’t have a bad experience. I am looking forward to my treatments this week. Now that the needles are both pointing the correct direction, it should be easier to stick me this week. The tracks should start to develop and the arm may scar up a little (which will help with the pain).

Thanks to the class reunion, I’ve rediscovered some high school friends. I’ve gotten four e-mails from people that I haven’t spoken to in ten years that have read through my blog. I have only had time to reply to two of the so far, but I’m working my way through my Inbox trying to get to everyone. So, if you’ve written, don’t despair. I am getting to you as quickly as I can.

I found a new service the other day that I really enjoy. I read several blogs, and I find that it’s easier to do if they are e-mailed to me. There’s a site, http://www.r-mail.org/ that allows you to subscribe to anyone’s blog and get it over e-mail. It just takes a couple of days to set up, and it works like a charm. They have a form on their web page that you enter the information in to, and it sends you a confirmation. It's easy!