My first "Annual" Kidney Exam

Good evening everyone!

I had my one-year post-transplant Glofil appointment on Tuesday. My score was 81. For those of you keeping track, I was 86.1 right after the transplant, 82 at the six-month mark. I asked the doctor (physician's assistant), and she said that the "normal" range for a post-transplant patient was between 40 and 60, so I am doing very well.

I received a Glofil-related question on my comments (on the last blog). Here's the question:

Jugie C has left a new comment on your post "You're a Genius":

My grandson (Montgomery, TX -- 10yo) had his 1st GloFil test today (01/15/08). He was born with inadequate kidney function. Can you point us to an explanation of what "normal" is (his was 21.9). My daughter was informed that 70-140 is the adult normal.

Well, Jugie, I asked the nephrologist about your question. She printed me a list from http://www.renal.org/ about Glofil results. For a person with Chronic Kidney Disease, the kidney function is measured (or estimated) with a GFR (Glomerular Filtration Rate). There are five stages but kidney function is normal in Stage 1, and minimally reduced in Stage 2.

Stage 1 is a GFR of 90+: Normal kidney function but urine findings or structural abnormalities or genetic traits point to kidney disease.
Stage 2 is a GFR of 60 - 89: Mildly reduced kidney function, and other findings (as for stage 1) point to kidney disease.
Stage 3 is a GFR of 30 - 59: Moderately reduced kidney disease.
Stage 4 is a GFR of 15 - 29: Severely reduced kidney function.
Stage 5 is a GFR of < 15: Very severe, or endstage kidney failure (sometimes called renal failure)

The nephrologist said that UNOS (the transplant people) require you to score less than 20 in order to qualify for a transplant. She also said that once you fall below 15, they normally recommend dialysis (depending on the patient, but it's <15 for almost everyone).

I also got my lab results back. My creatinine remains at 1.0 (which is good). My cholesterol levels all looked good. My bad (LDL) was at 61 (which is on the low end). My good (HDL) was a little lower than they like (only 36.0). And my triglycerides were at 139, which is excellent. The only recommendation is cardio-vascular exercise to improve my good cholesterol numbers. Aside from that, she was happy. My Phosphorus was a little low this week at 2.5 (with the normal being between 2.6 and 4.4). The doctor said to keep eating the foods that are higher in phosphorus (all the stuff I could not have on dialysis).

From glancing at the second page, my MONOCYTES were a little high at 0.84 (and the normal range is 0.10 - 0.50). The Internet said that monocytes are a second line of defense against infection. I'm guessing they are elevated due to this foreign kidney being in my body. I'll have to watch it on the next lab report and see if it remains a problem. This level has not been elevated in the past.

That's it for this week. I have another appointment on my birthday. I'm going to try and go in early to see if that helps with the congestion at the office. They have been remodeling their office, and are serving patients in a smaller rental building. It's crowded and there is never any parking. I'm hoping that perhaps being the first appointment of the day will give me a chance to get seen quickly and to get a place to park.

Have a great week. I'll try to post again before mid-March!

You're a Genius

So, I am not normally a fan of the "my blog says this about me" quizzes on the Internet. I saw this one on a friend's page, and she had been rated as "elementary level" and I wanted to see where I fit. It seems (probably based on the words POLYCYSTIC KIDNEY DISEASE in the title) that you have to be a genius to read my blog. So, good news for all of you. You're a genius.

So, just to make this a valid post, I will put in some information about me (and possibly my kidney). It has been cooler here in Texas over the last several days, and I am feeling it. Back in the summer, I was afraid that I was always going to be hot all the time after the transplant. But, it seems like that won't be a problem. I go to work and my thermometer says it is 73.9° F in my cubicle (though, I don't believe it, as the next cube over is 69.9º) and I am freezing. I have been enjoying a new blanket I got for Christmas and some new warm sock/slipper things.

My medication is still going well. This is my last week for 7mg of Prednisone. Next week, I move down to 6mg. The doctor said (several weeks ago) that I could move from 10mg to 5mg per day. I just had to reduce by one milligram every four weeks. He actually said every month, but it's easier for me to keep track of when I change if I do it every 28 days (since my medication holder is set for seven days). I don't notice much difference, but it is nice to be on less of the medication that makes you hyper and have more of an appetite.

I am working on being more regular about exercising. We got a pre-owned treadmill from some friends right before Christmas, so that has been nice. I can walk on it without having to drive to the exercise facility that is provided by work. And, yesterday was nice enough outside in the afternoon that I actually went out and rode my bike for a little while.

We celebrated Jenny's birthday on Sunday. She said that she really enjoyed it and doesn't mind growing older. Mine is not for two more months, so I get to make fun of her for being older than me once again (for a short time). I've enjoyed my last year (with the new kidney) and I hope that it can bring me through the next thirty years.

That's about it for today. The Glofil test is set for January 22. I should get to hear from the doctor about how great I'm doing and see if there is anything I can do to make it better. I'm always looking for ways to make the kidney last a little longer.

See you next time, geniuses!!

Year Two: Day One

Yesterday (January 11, 2008) officially marked my one year Kidney-Versary! (Yes, spell checker, I know that isn't a word, stop underlining it with that red squiggly line).

It has been a wonderful year. I just spent twelve months NOT having to go to dialysis. That was probably the best change for me. I also got to eat more food (like a normal person), and I was able to put on a little bit of weight. I now weight 185 lbs (which is good when you are 6 feet 2 inches tall). I got to spend more time at home with my wife, and have generally enjoyed life all the more since my transplant.

I'd like to thank everyone that has been praying over the past year. The doctors say that the first year of transplant is the hardest to get past. Once you make it one year, your chances of rejection fall greatly. I am hoping that the statistics will hold true for me and that I will get a few more decades out of this new kidney. Keep on praying that God will protect me and this wonderful transplanted kidney for many years to come.

I have a Glofil test coming up in about two weeks. This will give the doctors a one year picture of how my kidney is doing. I'll be sure to let everyone know what's going on after I find out. I should probably also have another bone density scan a week or two after that. Then all of my records should be up-to-date in their systems.

That's about it for today. More another day!!