Friday Clinic

It has been a long day, and I am now (finally) home for the weekend. The doctor changed our clinic appointments from Monday, Wednesday, and Friday, to Monday and Friday. That means that we will not have to live in Fort Worth next week. We will just drive down for the two appointments and then head back home after each one. It will make for some early mornings, but I think it will be better than having to stay out of town and live in a hotel.

I will start out with a few of my lab numbers from this morning:

• Potassium was 3.9 (down from 4.3 on Wednesday)
  
• Creatinine remains at 1.0
  
• BUN was 14 (up from 9, but still an excellent number)
  
• Glucose was 82 (which means that I should be fine as far as blood sugar goes)
  
• Hemoglobin is up to 12.7 (the normal range is 13.5 to 18)

I will probably stop tracking the glucose since there is not a problem with that anymore. The only other abnormal reading that I have been getting is my magnesium. It was 1.6 on 1/19, 1.6 on 1/22, 1.4 on 1/24, and 1.5 today. A normal reading is between 1.7 and 2.6 mg/dl. Following is what Wikipedia has to say about magnesium:

Magnesium ion is essential to the basic nucleic acid chemistry of life, and thus is essential to all cells of all known living organisms. Many enzymes require the presence of magnesium ions for their catalytic action, especially enzymes utilizing ATP, or those which use other nucleotides to synthesize DNA and RNA ... Although magnesium is present in many foods, it usually occurs in dilute form. As with most nutrients, daily needs for magnesium are unlikely to be met from a single serving of any single food. Eating a wide variety of foods, including five servings of fruits and vegetables daily and plenty of whole grains, helps to ensure an adequate intake of magnesium.

So, the doctor said that if my magnesium stays too low, that I would have to start taking some magnesium supplements.

In addition, I had a bone density scan done on Thursday. This scan is done on all new transplant patients, to get a base line of your bone density. The doctor said that I had a lowered bone density, a condition called "osteopenia."

What is Osteopenia?
Osteopenia refers to bone mineral density (BMD) that is lower than normal peak BMD but not low enough to be classified as osteoporosis. Bone mineral density is a measurement of the level of minerals in the bones, which indicates how dense and strong they are. If your BMD is low compared to normal peak BMD, you are said to have osteopenia. Having osteopenia means there is a greater risk that, as time passes, you may develop BMD that is very low compared to normal, known as osteoporosis.

For this condition, the doctor said that I would need to take calcium supplements with Vitamin D. He prescribed OsCal-D (500mg) to help increase my calcium levels and hopefully add a little bone density. It seems most likely that the prednisone can cause a lowered bone density. So, they are going to try and head off the problem early by putting me on calcium supplements. I guess we will be heading to the pharmacy tomorrow to see what we can find. I will be taking one of these pills twice a day for the next six months, at which time they will re-assess my bones and check the density again.

Speaking of medication, the post-transplant nurse called me this afternoon to alter my Prograf. Currently, I am taking 4mg twice a day. They said that my Prograf level was at the high end, so they lowered me to 3.5mg twice a day. The new 1/2 mg pills are on order and should be here in a few days. Until then, I will take 4mg in the morning and 3mg in the evening. Hopefully that will help balance out my levels (once I get the correct dosage in my system). It seems that Prograf is just one of those medications that has to be adjusted on a per-patient basis in order to keep the proper amount in your blood.

I also went by my old dialysis clinic this afternoon when we got back to town. I dropped off my Phoslo and Fosrenol medication to the clinic. Since my pharmacy requires me to order 90-day supplies of my medications, I had quite a bit of this phosphorus-blocking medication on hand. I wanted to be able to share this medication with other people that might have a harder time paying for much-needed medications. So, I dropped the medications off with the dietitian to distribute on an "as needed" basis. I know that I benefited from free medication before I started dialysis. I was on a "less good" health care plan that did not want to pay for Epogen shots (around $1500 each). The nephrologist I had at the time happened to have 4 shots in his office that a patient had dropped off after starting dialysis. One good deed and all ...

One other change. For those of you that receive my blog via e-mail, you will continue to receive it. I was just getting a large number of messages that I was forwarding each time I updated the blog, and my e-mail was about to start complaining. So, instead, I created a mailing list on Google Groups. Those of you that were receiving the mail before will continue to receive it in the exact same way. The only difference you will notice is a short footer explaining how you can subscribe or unsubscribe to the mail outs. You can forward this to your friends that want to be a part of the mail-outs. They can then subscribe if they want to. Also, on the upper right hand side of the blog page, you will notice a white block. You can put your e-mail address in this box and subscribe if you want automatic mail-outs whenever I update the blog.

So, let me know if there is a problem with your automatic mail-out. Otherwise, enjoy the new method of delivery (which should not show much change for you).

Please continue to pray for the following:

• Pray for my continued recovery from the transplant surgery
• Pray that the staples holding my incision closed will be ready for removal on Friday (that is when the doctor wants to take them out)
• Pray for the family of the kidney donor, as they are still grieving the loss of a family member
• Pray for my sleeplessness. The prednisone causes insomnia and I am taking sleeping pills. I would like a less addictive solution for this problem.

Thank you for reading the blog today. Let me know if there are any problems. And, feel free to sign up (if you are a new reader and want to receive automatic updates).