End of February Update

Hello everyone!

I am here to offer a quick update on how I have been doing since last Thursday. I have another clinical follow-up appointment scheduled for Thursday (in fact, I just got the automated call from the office reminding me to come in Thursday morning). I am feeling well, and looking forward to the office visit. It should be the last time I have to come for two weeks (hopefully).

I lowered my Prednisone dosage to 17mg per day starting yesterday. That's good news, since less medication is probably better for me. As I have mentioned before, the Prednisone has the most negative side effects, so it is good to take less of it. I should be down to 10mg per day starting by the end of April.

I have also continued to walk every morning. My speed is going up, though I have yet to start getting a real "work out" on the treadmill yet. If I get going too fast, I will have to start playing with the elevation, since I am not really looking to go running every morning!

Here are my last 9 days of walking results:

DATE	DISTANCE	TIME
02/19/07	2.70 mi	65 min
02/20/07	2.81 mi	65 min
02/21/07	2.89 mi	65 min
02/22/07	3.00 mi	65 min
02/23/07	3.02 mi	65 min
02/24/07	3.12 mi	65 min
02/25/07	3.13 mi	65 min
02/26/07	3.24 mi	65 min
02/27/07	3.25 mi	65 min

As you can see, I am now walking over three miles per day, which is great. My goal is still between four and five miles a day at the moment. Once I reach that, I will have to look in to increasing the treadmill's elevation to get a better work-out. But, I am personally pleased with the amount of stamina and endurance that I am building up. Hopefully, this will keep me feeling better throughout the life of my transplant.

That's about it for today. I am still working from home 20 hours per week. I am still talking to the Disability Insurance people to see about getting my part-time disability checks. I did get paid for all of my full time off (Jan 11 - Feb 4). I just have to get them to keep paying me until I get back to work full-time. I guess we'll see.

I have another appointment Thursday morning. I'll let everyone know more when I do!

Glofil Results and Lab Results

Welcome to the blog everyone. I have quite a bit of news for today, so sit back and relax, it might go a little longer than I plan.

Today was my second follow-up appointment at the Dallas Clinic since my kidney transplant in January. It was also the date of my first post-transplant Glofil test. You can read all about the Glofil test here: http://nmccart.blogspot.com/2007/02/upcoming-first-post-transplant-glofil.html

I arrived at the clinic around 11:30 am. The Glofil was scheduled to start around noon, and the doctor's appointment was set for just after the Glofil finished (around 2 or 3). I did my due diligence and drank a bunch of water for the last three days. In fact, I'd say I drank about 100 ounces of water a day since Monday, not to mention other beverages with meals. So, I arrived prepared to give a urine sample! They gave me the iodine solution, took my height, weight, temperature, and blood pressure, and sat me in a room with three other post-transplant patients. Then, once everyone was there, they gave me the injection of Glofil solution.

The guy who was running the test came in a few minutes later to tell us how much to drink. Three of us had to drink five glasses of water (about 200 ml each) and the fourth guy (who was much larger than any of us) had to drink 12 glasses. We were given 45 minutes to consume our water and wait. I drank my five glasses, and I read a book until it was time to give the first urine sample.

The procedure for the next couple of hours was drink, empty bladder (and have the output measured or something), get blood drawn, and drink again. The second and third sessions I only had to drink 2 glasses of water. Each interval was about 30 or 45 minutes. They measured something in the urine (perhaps volume) and also the level of solution in the blood (to see how much was being removed by the transplanted kidney).

My Glofil was 86.1. The technician said that this is an excellent result. There is no baseline for kidney transplant patients, but donors normally need to be between 80 and 120 (I believe) to be considered eligible to donate their kidney.

After that was finished, I saw the doctor. She gave me my lab results (which you will see below). My creatinine is down to 0.9 (from 1.0 the last several weeks). My hemoglobin is 13.7 (which is down a little from 14.3 last week, but still in the good range). My triglycerides were down a little bit from last week, which is also good news. The only thing the doctor told me was to try and consume a bit more milk and meat to get my phosphorus back up to normal.

She said my "GCT" was 58.0, which was a little bit high. I looked at last week's result, which was 64.0, and noticed that it had gone down. I asked her what that number meant. She said that it was a liver enzyme. She said it was normal for it to go up after surgery, and that it is good that mine is dropping to be in the normal range. She said it should not be a problem.

My White Blood Cell count was down to 3.0, which is a bit too low. The doctor said she was not going to worry about it since it was the first time it has been low. I think that if it were to be too low for a long time, they might want to change my anti-rejection medication dosages (I'm guessing).

The results from the 24-hour urine collection were also on my lab report. Everything looks pretty good, except the Urine Creatinine. I do not know if that number being low is good or bad, so I will have to ask them next week.

So, that's about it for today. I have an appointment next Thursday morning to be checked out again. The doctor said that by the end of the month, they will probably only have me come in every two weeks. I am guessing they will want to do that 4 or 6 times, and then maybe swap me to once a month. I told her not to hurry on my account, I would rather be safe than to go back to work earlier!

Here are the lab results for February 22:

PROCEDURE	RESULT	UNIT	REF RANGE
[Profile: CMP]
Creatinine	0.9	mg/dL	0.4 - 1.0
Blood Urea Nitrogen	11.0	mg/dL	8.0 - 20.0
Sodium	130.6 L	mmol/L	136.0 - 144.0
Potassium	4.0	mmol/L	3.6 - 5.1
Chloride	100.6 L	mmol/L	101.0 - 111.0
CO2	22.9	mmol/L	22.0 - 32.0
Glucose	111	mg/dL	74 - 118
Calcium	9.3	mg/dL	8.9 - 10.3
AST	26.0	U/L	15.0 - 41.0
ALT	45.0	U/L	17.0 - 63.0
Alkaline Phos	67.0	U/L	38.0 - 126.0
Albumin	4.1	g/dL	3.5 - 4.8
Total Protein	6.1	g/dL	6.1 - 7.9
Total Bilirubin	0.8	mg/dL	0.4 - 2.0
[Profile: GCT]
GCT	58.0 H	U/L	7.0 - 50.0
[Profile: MAGNESIUM]
Magnesium	1.4 L	mg/dL	1.8 - 2.5
[Profile: PHOSPHORUS]
Phosphorus	2.3 L	mg/dL	2.4 - 4.7
[Profile: CBC]
WBC	3.0 L	K/uL	4.0 - 11.0
RBC	4.04	M/uL	3.8 - 6.2
Hgb	13.7	g/dL	11.5 - 18.0
Hct	39.0	%	35.0 - 54.0
MCV	96.6	fl	80.0 - 100.0
MCH	33.9	pg	27.0 - 34.0
MCHC	35.1	g/dL	31.0 - 36.0
RDW	12.4	%	11.5 - 14.5
Platelets	254	K/uL	150 - 450
# Neut	1.94		1.40 - 6.50
% Neut	64.40	%	42.20 - 75.20
# Lymph	0.87 L		1.20 - 3.40
% Lymph	28.90	%	20.50 - 51.50
# Mono	0.16		0.10 - 0.50
% Mono	5.29	%	1.70 - 9.30
# Eos	0.01		0.00 - 0.70
% Eos	0.25	%	0.00 - 7.00
# Baso	0.04		-0.00 - 0.20
% Baso	1.16	%	-0.00 - 2.50
[Profile: CHOLESTEROL]
Cholesterol	142.00	mg/dL	0.0 – 200.0
[Profile: TRIGLYCERIDE]
Triglycerides	212.0 H	mg/dL	0.0 – 200.0
[Profile: Creatinine Clearance 24 Hour]
Urine Volume	4690.00	mls/24hr	-
Urine Collection	1440	Minutes	-
Urine Creatinine	36.7 L	mg/dL	400.0 – 2800.0
Creatinine Clearance	132.81	mL/min	80.00 – 125.00
Urine Creatinine 24 Hrs	1.72	gm/24 hrs	1.00 – 2.00
[Profile: PROTEIN: 24hr Urine Total]
Micro Total Protein	2	mg/dL	-
MTP/24HR	93.8	mg/24hr	-

Enjoy!

Monday, Feb 19 -- An Update

I see it has been about four days since I last gave everyone an update, so I am going to try and give a quick overview of everything that is going on with me at the moment.

For starters, I am feeling great! My energy level is good, my new kidney seems to be functioning very well, and I am enjoying life more like a normal person. Jenny and I attended a "Membership Celebration" at our church last night. It is an informal, informational setting that allows visitors to our church to learn about the church's core values and gives them a chance to become members. Jenny and I were there as "hosts" to assist three other couples that were thinking about church membership. It was good to be able to go to something like that, and I got an opportunity to speak to our pastor. He has been faithfully praying for me ever since I lost my kidney back in 2005. As we attend a large church, I do not speak to him personally that often, but when I do, he always asks how I am doing and lets me know that he is still praying. It was good to talk to him last night and let him know that I am feeling very healthy and that all of the prayers were appreciated. Oh, and all three couples at our table decided to join the church, so that's good news, too!

I am still preparing for my Glofil test on Thursday. They have me scheduled in the afternoon group for that day. I am also having my weekly follow-up clinic appointment that day, so I need to remember not to take my Prograf that morning. (I just moved my Prograf out of the Thursday morning container and in to the Thursday afternoon container, so I will not be taking it with my morning medications). The doctors do not want you to take the Prograf before you blood is drawn so that they can get an accurate level of how much Prograf is in your system and decided if you have too much or not enough in your blood to keep you healthy. Anyway, the Glofil test is coming up, and I am supposed to be hydrating myself all week in preparation. I have had about 30 ounces (887 ml) of water this morning. I think my goal is supposed to be 96 to 120 ounces (2839 to 3549 ml) of water per day for the three days prior to the test. That's the same as having 1 1/2 2-liters of water (or close to a gallon of water) per day. I know I did not drink quite that much yesterday, but I think it will be okay. It has been quite a while since I have been allowed to drink that much per day, especially since that was about what I tried to stick to between dialysis treatments. But, I will drink water throughout the day, and hopefully when I go take my test, I will be hydrated enough to not have to drink too much during the test, which is nice.

In other news, I am continuing to walk just about every day. I have walked nine out of the last ten days, and except for one day when I ran out of time, I have walked 65 minutes a day. I am slowly increasing my speed on the treadmill (I walked at 2.5 mph this morning). I called and talked to my mother on Saturday, and she noted that I was able to carry on a conversation with her the entire time I walked. She said that means that I am not working my cardio-vascular system quite hard enough. I reminded her that as of a month ago, I was leading a sedentary lifestyle, and it might take a little bit longer before I am up to the point of getting a "good" work-out. Here is my walking log for the past 10 days:

DATE	DISTANCE	TIME
02/10/07	2.28 mi	65 min
02/11/07	2.36 mi	65 min
02/13/07	1.61 mi	44 min
02/14/07	2.46 mi	65 min
02/15/07	2.48 mi	65 min
02/16/07	2.59 mi	65 min
02/17/07	2.59 mi	65 min
02/18/07	2.70 mi	65 min
02/19/07	2.70 mi	65 min

So, as you can see, with increased speed comes increased distance. In another couple of weeks, I should be up to about four miles per day. I don't know if that will be a good goal or not, but it is at least something to look forward to. Once I get to the point of breathing hard and having my heart rate up by the end of my hour, then I will work on using the "incline" function of the treadmill so that my speed and distance do not have to increase, but I can continue to get a better work-out.

Well, that should about do it for today. I have to call my disability contact at work and ask why I have not received any money from the short-term disability. I am thankful that Jenny and I have been putting money into our savings account for the past couple of years. Otherwise, it would be very hard to live (as I have only been paid for 44 hours in the past four weeks). So, I will give him a call and find out what is holding up my disability payments. Hopefully that will get resolved today and I will get some income this week!

Please pray that the disability payments get worked out. Continue to pray that I will remain healthy. Pray that my Glofil test goes well on Thursday and that my kidney function will be high. And, continue to pray for the donor family and their loss.

Thanks for reading today!

Upcoming: First Post-Transplant Glofil Test

As I promised yesterday, I am going to give you all a longer explanation of the Glofil test that I am going to be taking next week when I go in for my post-transplant follow-up clinic appointment.

Here is some information I got from http://www.netwellness.org/question.cfm/35412.htm:

Glofil is the trade name for a substance called 125-I sodium iothalamate. The name was derived from "glomerular filtration," which is a function of the kidneys. The kidneys' major job is to remove toxic waste products from the body. Blood passes through the kidneys and is continuously cleaned and purified. Each kidney contains approximately one million tiny filters called glomeruli. These microscopic filters work by sieving blood, retaining things that the body needs (such as blood cells and protein molecules), and discarding substances that are not needed, such as waste products that accumulate after processing of food. The waste products that are filtered out ultimately make up a large portion of the urine that is excreted from the body.

One way of measuring how well the kidneys work is to give a person a substance that gets filtered out by the glomeruli and excreted in the urine. Glofil is one such substance. It is administered intravenously, and its disappearance from the bloodstream is carefully measured and quantified. Because Glofil contains a tiny amount of radioactivity, the amount of it remaining in the blood can easily be determined by measuring the radioactivity in the body repeatedly over a period of time (usually several hours). The rate at which Glofil disappears allows us to calculate the rate at which glomeruli are filtering it out of the bloodstream, and thus to determine how well the kidneys are working. The amount of radioactivity in a typical dose of Glofil is less than that in a single chest x-ray.

So, you now have a technical idea of what this test entails. Now, I am going to transcribe the instruction sheet that they gave me to help me prepare (can I say I am studying for my kidney test?):

Glofil Procedure - Patient Instructions

You have been scheduled for a Glofil Procedure, to determine your kidney function.

Your Glofil Procedure will last approximately 3 hours. You will be with a group starting at the same time. The first group starts at 7:00 am, and the second group starts at 11:45 am. If you cannot make your appointment, PLEASE let us know, so we can reschedule.

ALL LATE PATIENTS MUST BE RESCHEDULED.

• You may eat a light meal (not heavy) up to 1 hour before your scheduled appointment.
• You may drink water any time.
• If you are on LASIX, you must take it more than one hour before your appointment.
• If you were given a small vial of iodine (Lugol's Solution) when you made the appointment, you may take it the night before by mixing the contents of the vial in approximately one ounce of juice. Diet Coke tastes the best, if you have that.
• You will want to arrive as hydrated at possible, by drinking plenty of water. We suggest 12 to 15 eight-ounce glasses of water each day. Do this for 3 days prior to your test, unless your physician instructs you otherwise or has orders for liquid intake restriction.
• You are advised that nausea is a commonly experienced side effect due to the volumes of water administered during the test.
• You will not be able to drink any liquid other than water during your appointment.
• Fresh filtered bottled water is provided by our facility.
• If you choose, you may bring at least one gallon of your own water for your test. The water may be cold but it must not have ice in it.
• Lastly, avoid alcohol consumption at least three days prior to the test.

Therefore, in an effort to make your experience as pleasant as possible, please try to comply with all suggested requests prior to and during your Glofil Procedure.

• When you arrive, we will need a fresh urine sample. Please plan accordingly.
• If you have not taken our famous Lugol's Iodine cocktail the night before, we will give it to you at least 15 minutes prior to your Glofil injection.
• You will be given a calculated amount of water to drink during your test.
• As previously advised, the amount of water given may cause discomfort and even nausea. Please, let your technician know so we can make the appropriate recommendations.
• You will be instructed to void urine and collect every drop and have blood samples taken at regular timed intervals during the three-hour test. Please, remain in the Glofil department during the testing. Advise your technician if you leave the area.
• You must not eat during the test, unless instructed.
• You should not have had anything to eat one hour prior to the test. This may cause nausea and additional un-needed discomfort.
• Avoid any caffeine and tobacco products during testing.

Other Considerations

• You will not have a Glofil Procedure done if you are allergic to iodine. If you are allergic to iodine, your physician will order an alternate method.
• You will not have a Glofil Procedure if there is any radiation present in your system. This would occur if you have recently had any type of scan or a stress test.
• You will not have a Glofil Procedure if you are breastfeeding.
• You should not have a Glofil Procedure if experiencing a menstrual cycle. We suggest that it be postponed.
• If you are unable to make several trips to the restroom under your own power, you will need to bring someone with you to assist you.
• Due to limited space, we ask that family members do not accompany patient in the Glofil waiting area, if fully occupied. Please use additional waiting areas provided so that we may accommodate all the scheduled patients. Any special requests regarding this may be discussed with the Glofil Technician at any time and we will certainly accommodate anyone if space is available.

If you have any questions or concerns, please call the Glofil Departmetn at xxx-xxx-xxxx ext 6269. Thank you, it is our pleasure to serve you.


So, there you have it. All my wonderful instructions. I guess I will start attempting to drown myself on Sunday or Monday, so that I am very well hydrated by Thursday afternoon. And, I have to remember to not eat after 10:30 on Thursday, and not to take my Prograf that day (though, that is because of my clinic appointment, not because of the Glofil Procedure).

I hope that information helped everyone understand what I will be doing next week. If you have any questions, feel free to post a comment or send me an e-mail!

Enjoy your week everyone!

Wednesday Clinic at the Dallas Transplant Institute

Hello everyone! I know that you have missed me, and I am back, reporting some new news for my loyal readers.

I had my first follow-up appointment at the Dallas Transplant Institute (DTI) this morning. DTI is about 45 minutes away from where we live, as opposed to the hospital in Fort Worth which was over ninety minutes away. So, it is a much nicer and easier drive, and I was glad to go where I will now receive my permanent follow-up (as far as I can tell).

The clinic is pretty crowded, as they see more than just post-transplant patients. They also have a staff of about ten doctors and physician's assistants, which means that they can see more than the one doctor in Fort Worth was able to. This clinic is where I will go for all of my blood work and other tests that need to be done (hopefully from now on).

We arrived around 8:35am for an 8:40am appointment. There was not much parking, or we would have been in about five minutes earlier. They drew my blood and took a urine sample around 9:00am, which I think was probably what they had planned. They drew three vials of blood today, and tested my lipid panel, even though they told me I did not need to fast for this lab work. Oh well, my numbers were a little high, but that's okay. If they had wanted me to fast first, they should have said so when I asked.

I saw a Physician's Assistant around 10:00. She went over the procedures at DTI, and then went over my lab reports. My creatinine is still 1.0, which is great. The only number she seemed to even worry about was my Triglycerides, which were at 282 mg/dL. That is a bit high, and she said they might have to test that one again when I am fasting. I said that I am exercising, and she said that would help. She also said I might need some dietary changes to help lower that number. I have a dietary guide, but I have not read it yet. Maybe I should do that!

In other news, they scheduled me for a "Glofil test" next week. This test accurately measures your kidney function based on how much of a certain radioactive iodine you can excrete in three or four hours. You have to be very well hydrated to take the test. It is a normal part of being a post-transplant patient, and I expect to take many more Glofil tests in my lifetime.

The Glofil test is scheduled for Thursday the 22nd. I am also going to go back to the clinic on that day to have my blood work and doctor's visit. They scheduled them at the same time for me so that I would not have to drive down there more than once next week, which is nice.

I also got a call this afternoon to lower my Prograf dosage from 3mg twice a day to 2.5mg twice a day. My Prograf levels were a bit too high, I guess, so they lowered them a little. Hopefully, this will help control some of the shakiness I am feeling in my hands whenever I try to do fine motor-skill related tasks (such as writing).

Well, that's about it for today. Here are my lab results. You may notice that they are in a slightly different order and are a bit different than my previous results. That is because I got them from a new clinic which has different software for processing and displaying results. It might make it more difficult to compare to older results, but all the important information is there.

Enjoy!

PROCEDURE	RESULT	UNIT	REF RANGE
[Profile: CMP]
Creatinine	1.0	mg/dL	0.4 - 1.0
Blood Urea Nitrogen	11.0	mg/dL	8.0 - 20.0
Sodium	137.8	mmol/L	136.0 - 144.0
Potassium	3.7	mmol/L	3.6 - 5.1
Chloride	110.8	mmol/L	101.0 - 111.0
CO2	24.7	mmol/L	22.0 - 32.0
Glucose	70 L	mg/dL	74 - 118
Calcium	9.3	mg/dL	8.9 - 10.3
AST	26.0	U/L	15.0 - 41.0
ALT	59.0	U/L	17.0 - 63.0
Alkaline Phos	75.0	U/L	38.0 - 126.0
Albumin	4.5	g/dL	3.5 - 4.8
Total Protein	6.4	g/dL	6.1 - 7.9
Total Bilirubin	0.7	mg/dL	0.4 - 2.0
[Profile: LIPID PANEL]
High Density Lipoprotein	65.2	mg/dL	35.0 - 85.0
Low Density Lipoprotein	79.8	mg/dL	0.0 - 100.0
Cholesterol	171.0	mg/dL	0.0 - 200.0
Triglycerides	282 H	mg/dL	0.0 - 200.0
VLDL	56.4		0.0 - 40.0
Cholesterol / HDL Ratio	2.6		-
[Profile: GCT]
GCT	64.0 H	U/L	7.0 - 50.0
[Profile: MAGNESIUM]
Magnesium	1.7 L	mg/dL	1.8 - 2.5
[Profile: PHOSPHORUS]
Phosphorus	3.0	mg/dL	2.4 - 4.7
[Profile: CBC]
WBC	8.2	K/uL	4.0 - 11.0
RBC	4.28	M/uL	3.8 - 6.2
Hgb	114.3	g/dL	11.5 - 18.0
Hct	43.2	%	35.0 - 54.0
MCV	101.0 H	fl	80.0 - 100.0
MCH	33.3	pg	27.0 - 34.0
MCHC	33.0	g/dL	31.0 - 36.0
RDW	13.2	%	11.5 - 14.5
Platelets	245	K/uL	150 - 450
# Neut	5.05		1.40 - 6.50
% Neut	61.60	%	42.20 - 75.20
# Lymph	2.63		1.20 - 3.40
% Lymph	32.10	%	20.50 - 51.50
# Mono	0.41		0.10 - 0.50
% Mono	4.95	%	1.70 - 9.30
# Eos	0.03		0.00 - 0.70
% Eos	0.40	%	0.00 - 7.00
# Baso	0.08		-0.00 - 0.20
% Baso	0.97	%	-0.00 - 2.50

Stay tuned tomorrow to hear all about the Glofil Procedure Patient Instructions! You won't want to miss it!

Walking for Exercise

I started seriously walking this week. The transplant doctor said that walking was good, safe exercise for a post-transplant patient. So, I have been heading down to the fitness center every morning to walk on the treadmill.

Here is a chart of how my walking has gone this week:

DATE	DISTANCE	TIME
02/04/07	1.17 mi	35 min
02/05/07	1.33 mi	40 min
02/06/07	1.50 mi	45 min
02/07/07	1.66 mi	50 min
02/08/07	1.92 mi	55 min
02/09/07	2.15 mi	62 min

The exercise has been good for me. It helps me feel better, overall. I think that I am now in better general health, especially if I am exercising every day. This week, I worked on getting my time up to one hour. As you can see from the chart above, I started with a little over a half hour, and have worked my way up to an hour, slowly.

My next step is to increase the distance that I walk. I will do this my increasing the speed on the treadmill. I started out walking about 2.0 miles per hour. This morning, I walked at about 2.1 miles per hour. This is comfortable, so I will probably do that all next week, just to get used to that time, speed, and distance.

Maybe the following week I will increase the speed to go as fast as is comfortable at a walking speed. I do not want to run, but walking is fine. So, I will slowly work my way up to a fast walking speed at about an hour.

I'll have to see, once I go back to work, what I want to do as far as exercising. I am trying to decide if I want to walk prior to work each day, or when I get home. If I go before work, then I can shower and eat after exercising and before going to work. If I exercise when I get home, then I will have to change clothes into some exercise gear (and be sweaty in the evening when I get home).

So, I will make that decision when I get to that point. Please pray that I will continue to feel well during my recovery (which is going great so far). I am supposed to go to the clinic on Wednesday in Dallas (instead of Fort Worth). I haven't received a call from the clinic yet, so I will have to check in with them on Monday and find out what time my appointment is.

Thanks for reading!

A Couple of Illustrations

Hello everyone! Welcome to Wednesday. I got bored with my camera phone the other day, so I thought I would take a picture of all of the medication that I am taking. Now, bear in mind that my camera phone supports a mighty 320 x 240 resolution. So, the not-so-wonderful picture is not your screen, it is the picture itself.

The picture is divided into four quadrants. The upper left-hand corner is all of the medications that I take at 9:00am. The upper right-hand quadrant contains the lunch-time medications. The lower left-hand corner is one pill that I take after dinner. And, finally, the bottom right-hand corder contains all of the pills that I take at 9:00pm.

You can see the big white round pill, which is an anti-fungal that I take four times a day. The purple-ish oblong pill is Cellcept, which is one of my immunosuppressants. There are four small white pills in the first picture which are the Prednisone (20mg total). The tiny white capsules are the Prograf, there are three in the 9am and 9pm pictures. The smaller white circular pill is the Bactrim (anti-bacterial). The pink oblong pill is the Valcyte (anti-viral).

In the bottom corner, you see two blue pills. Those are Cerefolin (a multi-vitamin). Another long oblong white pill (also in the first picture) is the Calcium + Vitamin D. There is also some folic acid, Zyrtec, and Lipitor in the bottom picture:


So, those are all of the medications that I take each day. They help me to stay alive (and healthy) and help keep my new kidney happy.

I also played with a diagram I found online of the human body. I drew a bunch of lines on it to show where all of my surgeries have been. For reference, the fistulas are on my left arm. The new kidney was put on the right side of my body. And, the surgical scar that is left from my kidney removal runs from the bottom of my sternum to right below my belly button.


Hopefully that picture came out well. Enjoy my skills with Microsoft Paint. And, enjoy the pictures (even if they are fairly simple).

Have a great day!

Lab Report from 02-05

Here is my lab report from Monday's clinic visit. You will notice that my creatinine is still 1.0 (which is great)! My other numbers are also in a good range. The only one that might cause me some concern is the BUN, which was a little higher than the normal range. The doctor did not seem worried, so I am not worried either.

Enjoy the lab report!

PROCEDURE	RESULT	UNIT	REF RANGE
[COMP METABOLIC]
SODIUM	139	MEQ/L	(136 – 145)
POTASSIUM	4.9	MEQ/L	(3.6 – 5.0)
CHLORIDE	104	MEQ/L	(98 – 107)
CO2	28	MMOL/L	(22 – 30)
ANION GAP	7	MEQ/L	(6 – 16)
GLUCOSE RANDOM	95	MG/DL	(75 – 110)
CREATININE	1.0	MG/DL	(0.7 – 1.2)
BUN	21H	MG/DL	(9 – 20)
BUN CREAT RATIO	21		(7 – 25)
CALCIUM	10.2	MG/DL	(8.4 – 10.2)
TOTAL PROTEIN	6.9	G/DL	(6.4 – 8.3)
ALBUMIN	4.5	G/DL	(3.5 – 5.0)
GLOBULIN	2.4	G/DL	(2.4 – 3.5)
A/G RATIO	1.9		(1.1 – 2.2)
BILIRUBIN TOT	0.3	MG/DL	(0.2 – 1.3)
ALK PHOS	95	U/L	(40 – 129)
AST	21	U/L	(10 – 50)
ALT	64H	U/L	(10 – 50)
[MAGNESIUM]
MAGNESIUM	1.8	MG/DL	(1.7 – 2.6)
[CBC]
WBC	7.2	K/UL	(4.5 – 11.0)
RBC COUNT	4.08L	M/UL	(4.5 – 6.00)
HEMOGLOBIN	13.5	G/DL	(13.5 – 18.0)
HEMATOCRIT	40.6	%	(40.0 – 52.0)
MCV	99.5H	FL	(80.0 – 99.0)
MCH	33.1H	PG	(27.0 – 33.0)
MCHC	33.3	%	(32.0 – 36.5)
PLATELET COUNT	166	K/UL	(140 – 440)
RDW SD	50.1	FL	(37.0 – 51.0)
RDW DV	13.7	%	(10.0 – 14.5)
MPV	10.5	FL	(8.5 – 12.0)
SEGS	58	%	(45 – 75)
LYMPHOCYTE	37	%	(20 – 45)
MONOCYTE	4	%	(2 – 9)
EOSINOPHIL	1	%	(0 – 5)
BASOPHIL	1	%	(0 – 2)
SEGS ABS	4.18	K/UL	(2.03 – 8.25)
LYMPHOCYTE ABS	2.66	K/UL	(0.90 – 4.95)
MONOCYTE ABS	0.29	K/UL	(0.09 – 0.99)
EOSINOPHIL ABS	0.07	K/UL	(0.00 – 0.55)
BASOPHIL ABS	0.07	K/UL	(0.00 – 0.22)
ABS NEUTROPHIL	4.18	K/UL	(2.07 – 8.80)
MANUAL BAND	0L	%	(1 – 4)
MAN METAMYELOCY	0	%	(0 – 1)
[PHOSPHORUS]
PHOSPHORUS	4.1	MG/DL	(2.7 – 4.5)
[RT UA]
URINE COLOR	YELLOW
URINE CHARACTER	SL CLOUD		(CLEAR)
SPECIFIC GRAVITY	> 1.030
URINE PH	5.5
URINE PROTEIN	POS 1+		(NEGATIVE)
URINE GLUCOSE	NEGATIVE		(NEGATIVE)
URINE KETONES	NEGATIVE		(NEGATIVE)
URINE BILIRUBIN	NEGATIVE		(NEGATIVE)
UR OCCULT BLOOD	POS 1+		(NEGATIVE)
URINE NITRITE	NEGATIVE		(NEGATIVE)
UR UROBILINOGEN	0.2	EU/DL	(0.2 – 1.0)
LEUKOCYTE ESTER	TRACE		(NEGATIVE)
URINE WBCS	30 – 50		(0 – 1)
URINE RBCS	15 – 30		(0 – 1)
EPITHELIAL CELL	RARE
BACTERIA	MOD		(ABSENT)
URINE CRYSTALS	PRESENT

Monday Clinic Update

Welcome to Monday evening everyone. I have gotten a few calls/e-mails today wondering if everything is OK, and it is. No need to worry, I was just busy today and therefore slow at blogging.

I had my final appointment at the clinic in Fort Worth this morning. The doctor said that everything is looking great. He had his nurse remove my staples from the surgery scar, and they did not have to use any steri-strips (since the wound had healed very well on its own).

The doctor also transferred me to the Dallas Transplant Institute (DTI). That clinic is much closer to home (about one hour rather than two). The doctor told me that I will be seeing a team of doctors rather than just one doctor. I may not see the same person two visits in a row, but the whole team has access to all of my reports and my data, so it should be OK. I will see next week when I go to the clinic. My next appointment should be Wednesday, the 14th.

So, I am feeling great. The doctor said that my heart burn was probably caused by the Cellcept. He said that I should just take some Mylanta or something similar to help with it. He would rather not reduce my Cellcept dosage since I am still within a month of my transplant. The doctor said that they might reduce it later on, if it is still a problem, but not right away.

I have been also experiencing a small amount of shakiness in my hands. They are not what I would call "tremors" but they are not normal steady hands. The doctor said that my minor shakiness was caused by the Prograf. He said that the levels in my blood might still be a little too high, but they did not call today to change my dosage, so I guess that was not the case.

I received today the "Prednisone Taper Schedule" from the nurse. This is a schedule that tells me how to reduce my Prednisone over the next several weeks. The reduction is as below:

Date	Dosage
Jan 11	20 mg / day
Feb 12	19 mg / day
Feb 19	18 mg / day
Feb 26	17 mg / day
Mar 5	16 mg / day
Mar 12	15 mg / day
Mar 26	12.5 mg / day
Apr 23	10 mg / day

So, starting Monday, I will be taking 19 mg of Prednisone a day. I doubt that there will be much change in the side effects until at least the 15 mg dosing. I do not know how quickly that I will notice the change, but it will be nice to take less medication.

Also, I got my computer from work today. My boss is ready to approve me to work 20 hours a week from home. All he has to do is to update a form that he submitted to have me off of work and then I can do some work from home. That will allow me to be paid part time from work and part time from the disability. That will give me something to do (which is nice) and also will help me get paid a bit better than disability.

That is about it for today. I have my full lab report from today's blood work, but since this post was so long, I will save it until tomorrow.

Thank you all for your continued interest and prayers!

Saturday Update plus 2007-01-29 Lab

Welcome to Saturday. I am going to let everyone know how I am doing today, and also will include my last lab report from my clinic appointments. So, for all of you medically minded readers, you can follow along more closely with my lab reports and see exactly how everything is looking. I shouldn't have another lab report until Monday when I go back to Fort Worth to see the doctor and have my staples removed.

So, more about today. I got a good night's sleep last night, which was nice. I think I am doing much better with the sleeping when I get some good exercise. I walked today for thirty minutes, for a total of one mile. Now that I am able to go for a full thirty minutes, I think I will slowly start increasing my speed/distance. Soon, I should be like a nice, healthy person ... and that will be nice.

The only problem I have been having is heartburn at night. I do not know if it is medication, or if it is what I am eating, or a combination. I guess I will have to let the doctor know about that on Monday. It was particularly bad last night. Luckily, the store-brand ant-acid worked fairly well. I was able to get some sleep, and that's what you need at night.

So, all is well for today. I am glad that I am feeling well and am recovering quickly. Thank you all for your prayers and support. I appreciate everyone looking out for me.

Here is the lab from Monday the 29th:

PROCEDURE	RESULT	UNIT	REF RANGE
[BASIC METABOLIC]
SODIUM	136	MEQ/L	(136 – 145)
POTASSIUM	4.4	MEQ/L	(3.6 – 5.0)
CHLORIDE	101	MEQ/L	(98 – 107)
CO2	24	MMOL/L	(22 – 30)
ANION GAP	11	MEQ/L	(6 – 16)
GLUCOSE RANDOM	84	MG/DL	(75 – 110)
CREATININE	1.0	MG/DL	(0.7 – 1.2)
BUN	12	MG/DL	(9 – 20)
BUN CREAT RATIO	12		(7 – 25)
CALCIUM	10.1	MG/DL	(8.4 – 10.2)
[MAGNESIUM]
MAGNESIUM	1.7	MG/DL	(1.7 – 2.6)
[CBC]
WBC	8.2	K/UL	(4.5 – 11.0)
RBC COUNT	4.26L	M/UL	(4.5 – 6.00)
HEMOGLOBIN	14.2	G/DL	(13.5 – 18.0)
HEMATOCRIT	42.6	%	(40.0 – 52.0)
MCV	100.0H	FL	(80.0 – 99.0)
MCH	33.3H	PG	(27.0 – 33.0)
MCHC	33.3	%	(32.0 – 36.5)
PLATELET COUNT	196	K/UL	(140 – 440)
RDW SD	53.4H	FL	(37.0 – 51.0)
RDW DV	14.5	%	(10.0 – 14.5)
MPV	10.4	FL	(8.5 – 12.0)
SEGS	55	%	(45 – 75)
LYMPHOCYTE	39	%	(20 – 45)
MONOCYTE	5	%	(2 – 9)
EOSINOPHIL	1	%	(0 – 5)
BASOPHIL	1	%	(0 – 2)
SEGS ABS	4.51	K/UL	(2.03 – 8.25)
LYMPHOCYTE ABS	3.20	K/UL	(0.90 – 4.95)
MONOCYTE ABS	0.41	K/UL	(0.09 – 0.99)
EOSINOPHIL ABS	0.08	K/UL	(0.00 – 0.55)
BASOPHIL ABS	0.08	K/UL	(0.00 – 0.22)
ABS NEUTROPHIL	4.51	K/UL	(2.07 – 8.80)
MANUAL BAND	0L	%	(1 – 4)
MAN METAMYELOCY	0	%	(0 – 1)
[PHOSPHORUS]
PHOSPHORUS	3.0	MG/DL	(2.7 – 4.5)
[RT UA]
URINE COLOR	YELLOW
URINE CHARACTER	CLEAR		(CLEAR)
SPECIFIC GRAVITY	> 1.030
URINE PH	5.5
URINE PROTEIN	NEGATIVE		(NEGATIVE)
URINE GLUCOSE	NEGATIVE		(NEGATIVE)
URINE KETONES	NEGATIVE		(NEGATIVE)
URINE BILIRUBIN	NEGATIVE		(NEGATIVE)
UR OCCULT BLOOD	TRACE		(NEGATIVE)
URINE NITRITE	NEGATIVE		(NEGATIVE)
UR UROBILINOGEN	0.2	EU/DL	(0.2 – 1.0)
LEUKOCYTE ESTER	NEGATIVE		(NEGATIVE)
URINE WBCS	3 – 5		(0 – 1)
URINE RBCS	3 – 5		(0 – 1)
EPITHELIAL CELL	RARE
BACTERIA	PRESENT		(ABSENT)
URINE HYALINE CAST	0 – 1

Enjoy!