2010 Top Kidney Disease Blog Award

It appears that I have "won" an award from [redacted]. I'm not quite sure what it all means, yet.

The email that I received states:
As a website dedicated to help those consider a career as a certified nursing assistant, we only provide the best information available. Whether it's a resource that helps patients cope with their illness, or provides ways to live healthier, we feel that it's necessary for those seeking to obtain this information. This is why we've featured your blog, as it is one of the best to teach our readers.

I realize that not very many people will really find this interesting. I like to see that people (or groups) have been reading my blog and actually found it helpful or at least useful to someone.

I'd like to publicly thank the readers from that website for their award. I hope that they are able to find the information that they are seeking from a patient's perspective.

In other news, I realize that I never posted about my October transplant appointment. I'll have to fix that (but not today).

See you next time!

September 15, 2010: Cardiologist Appointment

Hi there, faithful readers (or those of you that just happened to stumble onto this posting). Today is the updated that my normal readers were hoping to see last Sunday. Unfortunately, my free time in the morning was cut an hour short, so I was not able to get online and write up my explanation from my latest cardiology appointment.

I saw my "new" cardiologist about a month ago. I say new because the cardiologist that I used to go see has retired from practice. I think she wanted to spend more time with her family (of which I am in favor). So, the previous visit to my cardiologist, back in June was to check my heart and my mitral valve to make sure everything was still working correctly. You can read that post here: Cardiologist Appointment - June 15, 2010. The doctor thought he saw some disturbing signs, so he asked me to come back in three months, instead of my typical six, to have my heart reviewed again.

The post received a few questions, which I will endeavor to answer below. I did not know the answers myself, so I just asked the doctor to help me out :)

1) Please Explain Ejection Fraction

The ejection fraction is the volume difference between heartbeats. Normally, you would expect to see an ejection fraction of 60% to 65%. My current rating is between 55% and 60%. I asked, and the doctor said that an ejection fraction of less than 50% was very bad, and that they would want to get me into surgery if that were to happen.

2) What is the Thickness of Your Mitral Valve Leaflets?

Normal mitral valve leaflets (shown in the diagram at the bottom as MV) are usually around 5 millimeters thick. My leaflets are slightly thicker than normal, but nothing to worry about at this time.

3) Do you have any enlarged ventricles or atrium?

No, at this time my ventricles and atria are both normal sized. This question is important because the mitral regurgitation can cause the heart to expand in size, over time. If you heart starts to get larger, it cannot be made smaller again. So, part of what they watch for is to make sure that your heart is not getting too big and that your ejection fraction stays within safe tolerances.

4) Please explain regurgitation and prolapse (in regards to the heart).

Regurgitation is blood flowing the wrong way in the heart. In the diagram at the bottom of this post, you can see a rough drawing of the heart. Blood is supposed to flow from the Left Atrium (LA) to the Left Ventricle (LV) and then out of the Aorta (AO). Regurgitation is the arrow that shows blood flowing back across the Mitral Valve (MV) from the LV to the LA.

Prolapse is simply the valve action going back up into the Left Atrium (LA). Normally, your mitral valve (MV) should allow blood flow downward (in the drawing) from LA to LV. The valve leaflets should stop the blood from flowing back up. Mine do not do that quite as well as they should. This reverse action causes the leaflets to be a little spongy, and to eventually wear out.

The doctor is watching the size of my heart as well as the ejection fraction that the valve is allowing. When they start to head toward a more dangerous range, then we will start talking about surgery.

5) What's your current status, then?

OK - big question! I'm still doing fine. The doctor said that he did not see a recurrence of the problems that he thought he noted in June, so I will not see him again for six months (this was my normal schedule). I'm not in perfect heart health, as my Ejection Fraction is down to 55-60% instead of 60-65%. But, until there are any changes, then I will keep my ribcage intact!

Thanks for reading today! The drawing below is my sketch based on the sketch that the doctor gave me at my appointment. Please try an pretend that it looks like a heart.

My next post should be about the post-transplant follow-up that I had on October 7. If I'm lucky, I will write it up next Sunday. See you later!

July 8: Post-Transplant Appointment

I last posted to my blog back in July. It is now almost the end of September. The easiest thing to draw from this is that I am a busy person and do not place a top priority on my blog. The thing you may not think, immediately, is that being healthy does not make for as good of posts (in my opinion).

But, as I was at the doctor the last time I posted, I figured I might as well post about that particular appointment today (while I have a few minutes). My last visit to the nephrologist, for my post-transplant follow-up, was a great visit. My creatinine is at 1.0, which is good to see. My other numbers are all still good as well. I am always glad to see good lab reports as a part of my quarterly visits.

If I remember correctly, I was a bit sick the last time I visited the doctor. I had some sort of sinus infection, which led me to have a chest x-ray. The doctor did not see any signs of problems in my lungs, which was good. I got some antibiotics from my family doctor, and they seemed to clear up the infection fairly well.

The biggest problem with being sick, as a post-transplant patient, is that it takes a long time to get better. Even with medication, I was still coughing for weeks. It means that I have to be more careful when I get sick and make sure I talk to the doctors quickly.

In other news, since my Medicare ran out at the beginning of the year, I have been paying full price for my post-transplant medications. For prednisone, this is not really a big deal. For the Myfortic and Prograf, it is quite expensive. I contacted the two pharmaceutical companies that make those medications, knowing that they offer financial assistance. I received forms from both companies, and sent in the receipts for my medications. I got back a payment of $80 for three months of Prograf. I have not seen anything from Myfortic.

So, I think that posting on Sunday morning works well. I have finished my Bible study for the morning, but am still waiting on Hannah to wake up. If I remember, I'll even update again next week about my 3-month cardiology appointment (and answer some reader questions).

Stay tuned!

Cardiologist Appointment - June 15, 2010

Today is Thursday, July 08, 2010, and I am sitting at the Nephrologist's office with my company laptop and MS Word as my only friend. I realized that I have not blogged in WAY to long, and that it is time for me to update everyone on what has been going on. Today's post will concern my cardiology appointment from almost a month ago. I'll try to get another post later this week (or early next week) so that I don't have too much information in one post.

I saw my cardiologist back in June for my biannual (two times per year, not every two years) appointment with echocardiogram. They have been watching my mitral valve to make sure that everything is still working properly and that I am not getting worse.

Note: I said "they" because I recently changed cardiologists. The doctor that I had been seeing has "retired" to spend more time with her children. I'm all for this, as a principle, but was not overly excited to lose one of my favorite doctors. So, if she reads today’s blog, then she'll know I liked her. My new cardiologist is at the same practice, and was recommended by the previous one, so I'm not too worried about him. He's just new, and I will have to get used to him.

Now, I will get back to the appointment details. I had my echocardiogram, and it seemed about the same to me as all the others that I have received. However, when the doctor came to tell me the results, he had some bad news. It appears that my ejection fraction (I think) has gone from 60 to 70% down to about 55% (based on visual observation). This is not the best direction for that to go.

The doctor told me that he was slightly more concerned, based on the previous echocardiograms that had been taken. He said that he would like to see me every three months instead of every six months. He said that I still have a "moderately severe" mitral valve prolapse, but with the reduced flow through the valve, he'd like to see more often.

At some point in the future, I will need to have my valve replaced. It's not that time, yet, but the doctor wants to be careful and make sure that I do not suddenly have a major problem because of my mitral valve. So, he is going to watch me a bit more closely. I guess I will just have to wait and see.

Overall, it was a good appointment. The whole reason I was going in to have the echocardiogram every six months was to watch my mitral valve and make sure it was not getting worse. Since it has gotten a little worse, they now want to check me more often. Luckily, the echocardiogram showed what it needed to show, and they are now going to check me more often.

One day, I will need heart surgery to have my mitral valve replaced. I'm not sure what that will involve, but I'm sure it won't be pleasant. On the plus side, I've never had open heart surgery, so that will be new. It's always fun to have something to add to my "List of Surgeries."

That's it for today's post. I will have two more blog posts coming up soon, so stay tuned. Thanks for coming by to read.

Posting on Another Blog? What?

Good morning, everyone! It's 5:26 AM (CDT) here in Texas, and I'm writing a blog post.

"Why are you doing that?", you may be asking yourself? I'm glad you asked. A few weeks ago, the author of the distinguished blog http://parentingbydummies.blogspot.com/ sent me an e-mail asking if I would be willing to put up a guest post on her blog talking about what it is like to be a blogger, a parent, and a kidney disease patient. I think I may have failed her on two out of the three, but at least I know what the third thing (kidney disease patient) is!

"That's great, but it doesn't really tell me anything," you may be saying at this point. You're correct. I'm typing up this blog post early in the morning because my guest post should be appearing today on her blog, and I wanted to one billion readers that all came over here to visit to have something personal to read.

Please note: One billion is an approximation. I did a rough estimate that one in four people that see a link in a blog they like will follow it. I am also guessing that the aforementioned http://parentingbydummies.blogspot.com/ has four billion daily readers. My guess may be off by one or two (I didn't count heads or look at her blog stats).

I know the real reason you came by today. You were hoping that I found the pictures of my kidney that I scanned all those years ago. You are in luck! I found them, and will link to the photos, here. I didn't want to scare anyone off, so you actually have to click to see anything gross/awesome.

http://picasaweb.google.com/nmccart/NathanSKidney?feat=directlink

If you are still here, congratulations! If you had to clean vomit off of your keyboard, I am sorry. I vomited for about a month prior to having that removed (ugh).

Anyway, thank you all for coming by today. I just wanted to say that I am VERY thankful to God for all that he has done for me. I am alive today, which is wonderful. I have a beautiful wife and a wonderful (hopefully) daughter. I have a great church family, and a faith that helps me stay strong.

Enjoy the blog, and post comments anywhere you wish!

Please note: I plan to go back and edit this post later today once I get the direct link to my guest post on http://parentingbydummies.blogspot.com/

READ THE GUEST POST HERE:

http://parentingbydummies.blogspot.com/2010/03/make-new-ifriends-monday-polycystic.html

Three Years Post-Transplant

Thanks for stopping by, everyone! This week is my three year kidney-versary! I received my donor kidney on January 11, 2007. It's been a wonderful three years.

I had my annual Glofil appointment on Tuesday of this week. For those of you that do not follow me on Twitter or are not friends with me on Facebook, I had a great appointment! I scored an 80.2 on the Glofil this year, which is the same as what I got last year. Now, for a normal person with two kidneys, that would be an 80% kidney function. For a post-transplant kidney patient with only one functioning kidney, it's a really good score (according to the doctors). I'm glad that my kidney is still working well and that my body is still not showing any signs of rejection. Keep praying that it will stay that way for MANY years to come.

My creatinine was 1.0 again. This is really good, since it was 1.4 when I made a short visit to the Emergency Room a week or so ago. For some reason, I passed out and got to go to the ER. I was perfectly fine. The doctors said that it was probably dehydration. My guess is that it was due to being at home for three weeks with our new baby and not being on my normal water drinking schedule. My vacation ended at the end of December, so I'm back to work and back to drinking enough water on a daily basis.

I also had my annual bone density scan at the appointment. Although I did not see the doctor after having the scan, I did as the technician for an unofficial reading of the charts. She said that it looked like the bone density of my hip was the same as last year and the bone density of my spine had improved, slightly.

I did get some bad news in December. My cardiologist, whom I really like, is retiring to spend more time with her family. I told her that it would be fine, as long as she would continue to see me. Even though I am very sad, it's good for her. Her and her husband have several young children, and I hope that they enjoy this extra time that she will have with them. She recommended a new doctor at their practice (who started out as an army doctor) to take over my cardiologist. I will see him in about six months and let you know ...

That's about it for now. I'm wonderfully healthy, and it looks like my wife is enjoying her new role as a mother. Our baby is happy and healthy (as far as we can tell) and is gaining weight. We are going to have our pediatrician watch her and see if she develops any kidney problems. Hopefully, even if she does, it will be a VERY long time away.

Thanks for all the prayers. I hope everyone enjoyed the post. I'll see if I can put up stuff about my health more often (though, it is difficult from time to time being busy).