Friday, March 30, 2007

I Have a Big Head - And Little Arms!

I realize that the subject line does not pertain to today's post, but it is funny. If you have seen the commercial that I am thinking of, then you might laugh at that line, too.

I visited the doctor today for another post-transplant appointment. I saw someone new at the clinic, which is okay. They have a large staff at the clinic, and they see you as quickly as possible (which is nice). Today, it was a standard follow-up appointment, just to see how I was doing.

My creatinine was down to 1.0 (which is good news). I guess it was just a problem with dehydration that was causing my creatinine to go up a little bit. I will just continue to drink more water and keep myself hydrated. My cholesterol was 142, which the doctor said was good. She said that all of my lab number looked well, which is always good news. I prefer to hear good news from the doctors rather than bad news.

She had me increase my dosage of Cellcept from 250mg twice a day to 250mg three times per day. The Cellcept is an immuno-suppressant that helps me keep my new kidney. She also said that I no longer have to take my Mycelex (which is the anti-thrush medication). It seems that you only really need to take it for the first month after transplant. She said to hang on to it in case I had a problem, but that it was not likely. She also said that I can stop taking my Valcyte (anti-viral) once this month's supply runs out.

That should be about it. I started taking sodium bicarbonate this week, and it seems to be doing the trick. My CO2 levels were back to normal, and I have been having less heart burn than I did last week.

So, I think everything is going great. The doctor will probably keep increasing my Cellcept to as high as my body can stand it. That should give me the best chance of not rejecting my kidney. Hopefully, if we increase slowly, my body will get used to the medication and not be as uncomfortable.

That's about it for this week. The house inspector did not find too many problems (nothing major). We just have to get some pricing on the minor repairs that we decided needed to be done before we move in. I don't know exactly how much effort it will be, but we will see. Hopefully, the house will be ours in May (on our closing date).

Thanks for reading!

Friday, March 23, 2007

Friday Lab Update

Once again, we have come to Friday. I am here to give you my update from the visit with the doctor today.

I went in this morning to the clinic to have my blood drawn so I could see if I am healthy again. The doctor said that my creatinine was at 1.2 (which is still a little bit high). She said she would rather see me at 1.1 or below. The solution: drink more water! I told her that I had been drinking at least 80 ounces of water (plus other beverages on top of that) per day for the past week. She said to keep that up, and it should help. It seems I was still showing as slightly dehydrated (though, I do not know how).

Either way, I am doing fine. The doctor prescribed me some new medication (but I don't recall the name off hand, they didn't have any at the pharmacy today). I should be able to get it on Monday, as long as they get it in stock.

I did not get any order to change my Cellcept dosage. So, for now, I will continue to take 250mg twice a day. I may have to call back on Monday to see if they wanted to increase that or leave it alone. I guess that depends on if I think about it on Monday or not. I have to go visit with the house inspector Monday afternoon, so I may be too busy to call the clinic then. Perhaps Tuesday.

So, all is well with me. I will continue to drown my insides with water (and other beverages, to keep up my salt levels and such). I will keep going to the doctor (I have another appointment for Friday), and I will continue to take my medication (including the new one, after I get it).

So, keep praying that my body will continue to accept the new kidney and that I will stay healthy and happy. Oh, and pray that our house inspection goes well. We are looking to buy, and would not like our prospective home to turn out to be a trash pile.


Monday, March 19, 2007

Monday - How I am Doing

Welcome back to the blog everyone. I am proud to say that I am (according to the doctor) doing much better today than I was on Thursday of last week. Now, I say that because I have not felt any worse since I had my transplant in January. I have been feeling great, and I continue to feel wonderful as time goes on.

The problem I was having was with my creatinine. It had shot up from 1.1 to 1.4 (which is bad). The doctor was worried that I might be getting dehydrated. So, we stopped one of my immuno-suppressants (the Cellcept) for the weekend to see if that would help. My creatinine went down, so my body is obviously not a big fan of the Cellcept. The doctor prescribed me a lower dosage pill (250mg instead of 500mg) and wants me to start taking two per day on Thursday.

I originally was taking 4 (500mg) Cellcept per day, after my transplant. The doctor quickly switched me to 3 per day after he realized that four per day was making me sick. The new doctor wants to try to ease me back on the the Cellcept, and said I need to make sure to drink at least two liters of water per day with it. So, I will attempt to be better with my water drinking, and hopefully, I will see better results when I go back to see the doctor on Friday!

So, my creatinine was 1.1 today (which is better). The rest of my lab results seemed unremarkable, so I will not bother you with them. Needless to say, I think that all is well and that I will try to enjoy the lower dosage of my medication on Thursday.

I'll talk to you all again on Friday, after I have another doctor's visit.

Friday, March 16, 2007

Friday Update on My Kidney

As you may have guessed, I visited the transplant clinic again today (after hearing that my creatinine on Thursday was up to 1.4). I arrived at 8:30 this morning for my 9:00 blood work, and didn't get out of the office until nearly 11:00. I guess it was a little bit tougher to get squeezed in to an appointment that it is to schedule in advance. That will teach me to have messed up numbers. I'll have to fix that for next time.

My creatinine today was down to 1.3 (which is a little better). The doctor asked if I was still having problem with diarrhea, which I was. The Cellcept (or Myfortic) can cause that side effect in patients. The doctor originally had me down to three Cellcept per day instead of four, and that helped quite a bit. The new doctor switched me to the Myfortic to lessen these side effects, but it does not seem to have helped that much.

The doctor sent me home today with the following instructions:
  1. Stop taking Myfortic/Cellcept for the weekend
  2. No dairy products
  3. Take Immodium as needed
  4. Do stool cultures and bring back on Monday
  5. Make a future appointment with GI doctor
So, lots of fun for the weekend. Don't ask me any questions about #4, because I probably will not answer them. It's not a subject with which I am overly comfortable, so no poop questions!

Anyway, I will be returning to the doctor on Monday, and hopefully we can work out this latest problem. In the meantime, I will be drinking plenty of fluids in a hope to not be dehydrated. That is the biggest risk at the moment. Being dehydrated is a problem for the new kidney, so I don't want to cause any problems. I guess I'll just drink a bunch more fluid and hope for the best.

I should know more on Monday (or maybe not). I guess it depends on if the doctor can evaluate my samples immediately or if it will take a few hours. If I learn anything (like if I have a virus or something) then I'll let you know. Otherwise, you'll hear from me again when I learn something!

Have a good day!

(Oh, and enjoy my birthday on Sunday. I'll be 29.)

Thursday, March 15, 2007

Thursday - Not so Good Today

I just got a call from the Dallas Transplant Institute. They said that my creatinine is up to 1.4 (which is bad). The lady said that I need to come in the the office tomorrow to find out what is wrong. She advised that I make sure that I am well-hydrated for the rest of the day.

They just ran lab work this morning, so I do not know if there is anything else wrong. I will be seeing the doctor tomorrow morning (Friday). I guess he will let me know what to do to get my creatinine back down to normal.

Please pray that my creatinine will go lower and that there will not be anything wrong with me. Thanks!

Thursday, March 08, 2007

Lab Update from Monday and Thursday

Greetings blog readers! With today comes another chapter in the ever-so-interesting world of Nathan's Lab Reports (patent pending). If you remember our last conversation, I had a slightly higher creatinine than I had in the past, so the doctor had my blood drawn both Monday and Thursday to see if there was a problem.

The blood draw last Thursday, this Monday, and this Thursday all showed that my creatinine was up to 1.1. The PA that I saw this week said that I should not worry. I have gained about ten pounds since I was in the hospital to get my transplant, and higher mass can cause higher creatinine. She said not to worry about it, and that it was not a problem.

She also congratulated me again on my high number from the Glofil test. She said I should be very pleased with my new kidney and at how well it was functioning. She also said that she didn't see any other problems with my other labs.

I am going to try and list the full lab results for Monday and Thursday below. It might not fit on everyone's screen, and I apologize. Just change your resolution to 1024x768 or higher today to view the report, and then you can switch back to whatever you were using before.


PROCEDURE 03/05/07 03/08/07 UNIT REF RANGE
[Profile: CMP]
Creatinine 1.1 H 1.1 H mg/dL 0.4 - 1.0
Blood Urea Nitrogen 11.0 12.0 mg/dL 8.0 - 20.0
Sodium 139.8 140.0 mmol/L 136.0 - 144.0
Potassium 3.5 L 3.3 L mmol/L 3.6 - 5.1
Chloride 108.0 107.2 mmol/L 101.0 - 111.0
CO2 25.7 26.1 mmol/L 22.0 - 32.0
Glucose 115 105 mg/dL 74 - 118
Calcium 9.5 9.6 mg/dL 8.9 - 10.3
AST - 24.0 U/L 15.0 - 41.0
ALT - 48.0 U/L 17.0 - 63.0
Alkaline Phos - 68.0 U/L 38.0 - 126.0
Albumin 4.4 4.6 g/dL 3.5 - 4.8
Total Protein - 6.5 g/dL 6.1 - 7.9
Total Bilirubin - 0.7 mg/dL 0.4 - 2.0
[Profile: GCT]
GCT - 59.0 H U/L 7.0 - 50.0
[Profile: MAGNESIUM]
Magnesium -
1.7 L mg/dL 1.8 - 2.5
Phosphorus 3.1 3.5 mg/dL 2.4 - 4.7
[Profile: CBC]
WBC 8.4 7.9 K/uL 4.0 - 11.0
RBC 4.46 4.51 M/uL 3.8 - 6.2
Hgb 15 15.1 g/dL 11.5 - 18.0
Hct 42.7 43.2 % 35.0 - 54.0
MCV 95.8 96.0 fl 80.0 - 100.0
MCH 33.7 33.5 pg 27.0 - 34.0
MCHC 35.2 34.9 g/dL 31.0 - 36.0
RDW 12.4 12.5 % 11.5 - 14.5
Platelets 223 214 K/uL 150 - 450
# Neut 5.33 4.77
1.40 - 6.50
% Neut 63.60 60.10 % 42.20 - 75.20
# Lymph 2.59 2.38
1.20 - 3.40
% Lymph 30.90 29.90 % 20.50 - 51.50
# Mono 0.32 0.53 H
0.10 - 0.50
% Mono 3.84 6.65 % 1.70 - 9.30
# Eos 0.04 0.08
0.00 – 0.70
% Eos 0.51 0.95 % 0.00 – 7.00
# Baso 0.1 0.19
-0.00 – 0.20
% Baso 1.24 2.41 % 0-0.00 – 2.50

Tuesday, March 06, 2007

Creatinine Still at 1.1

When I saw the doctor on Thursday, my creatinine was at 1.1. This was higher than the 0.9 or 1.0 that it had been since my transplant. So, the doctor advised that I go to the clinic on Monday (yesterday) to have my blood drawn again to make sure that I was okay.

I got a call from the clinic this morning. They told me that my creatinine was still at 1.1. This is not an "abnormal" number, it is just higher than I had been, so the doctor wants to watch it. I will go back to the clinic for another appointment on Thursday, so hopefully, the doctor will let me know what to do about this.

The creatinine is a reflection of how well your kidney is functioning. Basically, the higher the number, the worse the function. So, 0.9 is much better than 1.1. I will just have to wait until Thursday to see if I need to do something or make any changes.

I will let you know what I learn after my appointment! Enjoy your day.

Thursday, March 01, 2007

Post-Transplant Clinic: March 01

I visited the clinic this morning as a part of my post-transplant follow-up appointments. The doctors have been seeing me every week since the end of January.

The important thing to note from today was that my creatinine was up to 1.1 (it had been at 1.0 for several weeks, and was actually down to 0.9 last week). The doctor said that, because it went up, she wants me to come in for blood work on Monday, and a follow-up on Thursday of next week. So, I will not be going to twice-a-month appointments quite yet. We want to make sure that everything is okay before we start reducing appointments.

The doctor said that changes in the creatinine can be caused by the Prograf. She said that if there is too much Prograf in your system, it can make the creatinine start to rise. She also said it could account my my GCT not going down as fast as some other people. If you remember from last week, the GCT is a liver enzyme that normally is up after surgery, but should fall back in to the normal range if I am healthy.

Last time, I mentioned that my Urine Creatinine seemed low. The doctor said that was only because of the high urine output I had in my 24-hour urine. She said not to worry, and that everything is normal. She also was very pleased with my Glofil results, saying that a good number would be between 50 and 100 (and I was 86.1).

So, that's about it for today. I got an e-mail from the disability department saying that they have approved part-time disability from February 6 through February 23. That should show up on my next paycheck, so that's a good thing.

Here are my lab results from today:
[Profile: CMP]
Creatinine 1.1 mg/dL 0.4 - 1.0
Blood Urea Nitrogen 12.0 mg/dL 8.0 - 20.0
Sodium 142.0 mmol/L 136.0 - 144.0
Potassium 4.3 mmol/L 3.6 - 5.1
Chloride 108.3 mmol/L 101.0 - 111.0
CO2 29.2 mmol/L 22.0 - 32.0
Glucose 100 mg/dL 74 - 118
Calcium 9.8 mg/dL 8.9 - 10.3
AST 23.0 U/L 15.0 - 41.0
ALT 44.0 U/L 17.0 - 63.0
Alkaline Phos 71.0 U/L 38.0 - 126.0
Albumin 4.4 g/dL 3.5 - 4.8
Total Protein 6.3 g/dL 6.1 - 7.9
Total Bilirubin 0.7 mg/dL 0.4 - 2.0
[Profile: GCT]
GCT 56.0 H U/L 7.0 - 50.0
[Profile: MAGNESIUM]
Magnesium 1.7 L mg/dL 1.8 - 2.5
Phosphorus 3.7 mg/dL 2.4 - 4.7
[Profile: CBC]
WBC 7.4 K/uL 4.0 - 11.0
RBC 4.39 M/uL 3.8 - 6.2
Hgb 14.8 g/dL 11.5 - 18.0
Hct 42.6 % 35.0 - 54.0
MCV 97.0 fl 80.0 - 100.0
MCH 33.7 pg 27.0 - 34.0
MCHC 34.7 g/dL 31.0 - 36.0
RDW 12.1 % 11.5 - 14.5
Platelets 244 K/uL 150 - 450
# Neut 3.96
1.40 - 6.50
% Neut 53.70 % 42.20 - 75.20
# Lymph 2.64
1.20 - 3.40
% Lymph 35.90 % 20.50 - 51.50
# Mono 0.52
0.10 - 0.50
% Mono 7.03 % 1.70 - 9.30

Thanks for reading!