toDwI'ma' qoS yItIvqu'

Welcome everyone once again to my blog. I know, I don't post for six weeks, then I get on here twice in almost no time at all. What's the world coming to?

You might have noticed the title of today's post. I've been brushing up a little bit on the Klingon language, and discovered how one might wish a speaker of Klingon a Merry Christmas. You would say, toDwI'ma' qoS yItIvqu' or literally ''Our-savior's birthday you-enjoy!''). Why do I know this? Well, I think if you've been reading the blog up to this point, that answer is quite obvious.

Here's the latest news from the cardiologist: my mitral valve prolapse continue to be "moderate to severe," as it was six months ago. She said that she was pleased, and I will have to come back in six months to have another echo cardiogram and let her see if it stays the same. She also asked if I had noticed any more palpitations, but it had only been two days since I had last seen her, so I had to tell her no. I had mentioned at my last appointment that I noticed my irregular heartbeat about once a month or so, but it is not too bad (just noticeable).

Well, that's about it for me for this week. I hope everyone enjoys their Christmas and any time off of work that they might receive. I've got a picture (not all that great, but what do you want) of my Christmas tree for everyone to enjoy!



Until next time, remember the words of the Christmas cow, "Looooooooooow"

Merry Christmas Everyone

Luke 2: 1-20

1And it came to pass in those days, that there went out a decree from Caesar Augustus that all the world should be taxed.

2(And this taxing was first made when Cyrenius was governor of Syria.)

3And all went to be taxed, every one into his own city.

4And Joseph also went up from Galilee, out of the city of Nazareth, into Judaea, unto the city of David, which is called Bethlehem; (because he was of the house and lineage of David:)

5To be taxed with Mary his espoused wife, being great with child.

6And so it was, that, while they were there, the days were accomplished that she should be delivered.

7And she brought forth her firstborn son, and wrapped him in swaddling clothes, and laid him in a manger; because there was no room for them in the inn.

8And there were in the same country shepherds abiding in the field, keeping watch over their flock by night.

9And, lo, the angel of the Lord came upon them, and the glory of the Lord shone round about them: and they were sore afraid.

10And the angel said unto them, Fear not: for, behold, I bring you good tidings of great joy, which shall be to all people.

11For unto you is born this day in the city of David a Saviour, which is Christ the Lord.

12And this shall be a sign unto you; Ye shall find the babe wrapped in swaddling clothes, lying in a manger.

13And suddenly there was with the angel a multitude of the heavenly host praising God, and saying,

14Glory to God in the highest, and on earth peace, good will toward men.

15And it came to pass, as the angels were gone away from them into heaven, the shepherds said one to another, Let us now go even unto Bethlehem, and see this thing which is come to pass, which the Lord hath made known unto us.

16And they came with haste, and found Mary, and Joseph, and the babe lying in a manger.

17And when they had seen it, they made known abroad the saying which was told them concerning this child.

18And all they that heard it wondered at those things which were told them by the shepherds.

19But Mary kept all these things, and pondered them in her heart.

20And the shepherds returned, glorifying and praising God for all the things that they had heard and seen, as it was told unto them.

Merry Christmas everyone. It has been a few days since I posted, so I thought I would give out a quick update. Last week I mentioned that I had the nurse turn my dialysis machine up from 400 ml/min to 450 ml/min. That means that the machine can now clean about 12.5% more blood during each treatment. Since the doctor was not there this week, I spoke to the Nurse Practitioner that was doing rounds at the clinic. I had her write in my orders that my machine should run at 450 ml/min (whenever possible). My fistula has been working properly, and that is always nice. I have enjoyed having the machine run faster and getting more blood cleaned during my four hours. Hopefully, my arm will continue to cooperate and I will continue to receive better treatments.

No new news about Kala, yet, for those of you still wondering. Her tests are scheduled for January 2 and January 18. After that, we should hear from the transplant committee and be able to set up a surgery date. Then, I will switch from dialysis to "post-transplant" doctor's appointments, all the time, at least for a couple of months. Hopefully, you will be able to enjoy my "I had to give another urine sample today" posts as much as you have enjoyed the dialysis postings!

That's about it for today. I have been getting quite a few e-mails from my readers (all over the world!). It is nice to hear from you every time you write. And, if I have not replied to you, that is not because I am ignoring you. It is because I have not gotten to you yet in the e-mail queue. And, you can always post comments on the blog (which everyone can read). I will try to reply to you (if you leave an e-mail address).

Thanks for coming by today! Enjoy your Christmas with your family.

Merry Christmas

It has been about a week since the last time I posted. I will try to update everyone here quickly. I got my treatment moved up on Christmas Eve so that Jenny and I could go to the Christmas Eve service at church. I had off Friday of last week and Monday of this week, so I have been enjoying some vacation time at home with Jenny. We got to watch TV, play some games, and just spend time together. It has been quite nice.

I noticed that I have a couple of new comments that have been posted since the last time I wrote them out. Here they are:


At 12:58 PM, anu said...

Hi Nathan,

I wish you Merry Christmas and a healthy, happy new year 2006.

I pray that you get a kidney and the transplant is successful and you lead a happy life:)

god bless.

Anu, thank you for your well wishes. I did have a great Christmas, and I am looking forward to an entire happy 2006. I will be tested for transplant next year, and that can only lead to good things. I am looking forward to the day I get my transplant, and hope that it will improve my quality of life. Thanks!


At 2:28 PM, Vlademar said...

Nathan,
This is Vladc***@***.com,aka Lee Vlademar AKA Lee Batchelor.
That last name should bring back ancient memories from Sunnymede. I see Angela and your mother here at Coleman Pharmacy often. I am no retired and work there part time. It's a lot of fun. Almost as much fun as the old days at Sunnymede. I wanted to let you know how proud I am of you and how your are handling your situation. I know that God is leading you through your life as a responsible, productive part of society who happens to have a temporary handicap. You will beat this and be totally healed. Have fun with your mother and Angela while they are down there this weekend. You will always have my prayers. I want to thank your wife for taking care of one of my Kids. You know how I am about My kids.

Love,
Miss Batchelor

Well, for those of you that don’t know, that was one of my fourth grade teachers from back in Fort Smith, AR. I see that she is working at the local pharmacy where my mom and sister both go. It is always good to hear from someone that has known me from long ago. I have yet to write her back, but I will do so (most likely this week, in case you are reading!) I am thankful that my mother continues to share my story with those around her that know me, and that everyone has the ability to catch up on my life through this blog.

Well, that’s about all for today. I am heading off for another four fun hours of dialysis. But, it won’t be too bad. Jenny is off work and is supposed to visit me today. Yippie!!

December Lab Report

It is time, once again, for Nathan’s Lab Report. I have noticed that the web site does NOT like me to submit my labs in a table, so I am just going to do a bulleted list today. I will put the test and my results first, with expected values in parenthesis. And, I am going to try to put low values in blue and high values in red. I’ll see if I can find my old report to discuss the changes after the list.

• WBC: 4.68 – 1000/mcL (4.80 – 10.80)


• RBC: 3.20 – mill/mcL (4.70 – 6.10)


• HGB: 10.3 – g/dL (14.0 – 18.0)


• HCT: 29.2 - % (42.0 – 52.0)


• MCV: 91 – mcm3 (80 – 94)


• MCH: 32.1 – pg/cell (27.0 – 31.0)


• MCHC: 35.2 – g/dL (33.0 – 37.0)


• HGB X 3: 30.9 - % (42.0 – 54.0)


• Pre-dialysis BUN: 29 – mg/dL (6 – 19)


• Pre-dialysis CREATININE: 7.1 – mg/dL (0.5 – 1.2)


• POTASSIUM: 4.0 – mEq/L (3.3 – 5.1)


• BICARBONATE: 22 – mEq/L (22 – 29)


• ALKALINE PHOS: 87 – U/L (40 – 129)


• AST/GOT: 20 – U/L (13 – 39)


• TOTAL PROTEIN: 6.6 – g/dL (5.9 – 8.4)


• ALBUMIN (BCG): 4.2 – g/dL (3.8 – 5.2)


• CALCIUM: 9.2 – mg/dL (8.4 – 10.2)


• PHOSPHORUS: 4.6 – mg/dL (2.6 – 4.5)


• Ca X P PRODUCT: 42 – (<55)


• SODIUM: 139 – mEq/L (133 – 145)


• CHLORIDE: 102 – mEq/L (96 – 108)


• IRON: 59 – mcg/dL (45 – 160)


• UIBC: 184 – mcg/dL (110 – 370)


• TIBC (CALC): 243 – mcg/dL (228 – 428)


• TRANSFERRIN SAT. (CALC): 24 - % (20 – 55)


• Post-Dialysis BUN: 8 – mg/dL (6 – 19)


• UREA REDUCTION RATIO: 72 - % (65 – 80)


• HBsAg: Negative (Negative)


• CORRECTED CALCIUM: 9.0 – mg/dL


• CORRECTED Ca X P PRODUCT: 41

As always, the important numbers to see are the post-dialysis BUN and the Urea Reduction Ratio. My BUN is 8, which is about the same as I have been seeing the last several months. My URR is 72, which is a bit worse than what I have been seeing, but I attribute that to the fact that I was receiving dialysis through the neck catheter on the day they took my blood for the labs. The neck catheter did not provide as good of a treatment.

My phosphorus shows that it is high, but it is an acceptable value for a dialysis patient. They want us to score between 3.5 and 5.5, so I am right on target. I would like to try to get it below 2.6, but I don’t know what the likelihood of that is, given that I am on dialysis. My hemoglobin is low (meaning anemia) and that is normal. They lowered my anemia treatment last month, and I guess they will have to raise it back up again this month. My potassium is still lower than they prefer, so they continue to dialyze me using the 3K solution. Of note, my average fluid weight gain is 0.76 kg (or 1.1% of my dry weight). A good fluid weight gain is between 3% and 5% of your dry weight, so I am not having any problems with fluid overload. In fact, the dietician said I could drink some more if I want to.
That should be about it for today. I go to see the vascular surgeon next week, and he will tell me how well my fistula revision is healing. Hopefully, we can go back to using it soon and see if I will receive better treatments. Not that I miss the needles, because I don’t. But, I do want the best treatment possible.

I also learned that I will have to keep my chest catheter covered for as long as I have it. For some reason, I though I could remove the bandages at some point, but I guess not. They will keep changing the bandages and cleaning the site at every dialysis treatment until the catheter is removed. Also, I got my treatment moved up to the lunch-time shift for Saturday so that I can go to the Christmas Eve service at church.

Thanks for coming by to read. See you all later!

Thyroiditis

I went and saw an endocrinologist on Thursday afternoon. He told me that I have what appears to be a simple inflammation of my thyroid. I guess this is not uncommon, and he made it seem like my kidney disease may have been the cause, though they could never tell for sure what caused it.

You might be asking, what does the thyroid gland do? Well, I went and searched for that answer, and found it at: http://www.bestdoctors.com/en/askadoctor/b/blum/mblum_061200_q1.htm
The gland produces a hormone -- thyroid hormone -- that regulates the metabolism of the body. That is, it influences the ways oxygen is utilized at a cellular level and in many of the body's organs.

This in turn is expressed in various ways, including effects on a person's body temperature, excitability and mood, pulse rate, digestive function and other processes which are required for the support of life.

So, my thyroid is sick (or, was sick). It got inflamed and spit out all of the hormone that it was holding. A normal thyroid gland will produce hormone, and store it until the body needs it. Then, it releases that hormone in a timely manner, and produces more to always have a full store. When the thyroid gets inflamed, it releases all of the hormone that it was storing into your blood stream. That causes your thyroid hormone level to be too high, and then the thyroid stops producing hormone. That is where I am right now. My level of hormone is too high, and my thyroid is producing almost no hormone to refill its stores, as it does not think that I need any more in my body. Once the levels in my blood stream go down, the thyroid will have to play catch-up to get my levels back to normal. This may involve my thyroid hormone level going up and down around the normal level for about one year until it is settled out.

I am supposed to get blood work done in January and February to check my hormone levels, and then go back to the endocrinologist to see if everything is working out the way he thought it would and to see if I will need any medication (in case my levels get too far out of sync).

I have received two comments recently that I would like to share with everyone:


http://nmccart.blogspot.com/2005/12/pre-transplant-orientation.html
At 6:18 AM, Joeski said...
I too have PKD, and found your site thru google's blog search. I went thru dialysis via the chest catheter for 10 months before I was transplanted. That was almost 4 years ago- yet your words make is seem like yesterday. This is the first post I have ready, so I will look back to see more of your story before I comment further.
At 11:17 AM, Joeski said...
I have just read your entire blog since yesterday. Your situation is very much like what I went thru before my transplant almost 4 years ago. I too have PKD. I had one kidney removed in 1995 that was as large as the ones you posted. My other one limped along until 2001, when it had to be removed also. Same size. I was only on dialysis for 10 months before a match came up. My blood type is B+. I live in the Richmond, VA area. The transplant is well worth the time and testing involved. I did not like dialysis at all. I was constantly fighting to get my dry weight increased, as I lost a lot of weight in the hospital while they tried to save my last kidney. I just want to wish you good luck, and you will be added to my prayers. Remember to thank your wife every day for the support. I would never have made it thru everything as well as I did without my wife's love.

It is good to hear from someone that also has PKD and has had a successful transplant. I have only been in dialysis for about five months, and I would love to be able to get a transplant that quickly. I am guessing that Joeski had a living donor (which is the best way to get a transplant, as far as I can tell). I’ve had the fights with getting my dry weight increased just 1.5 kg since I started at the clinic. I am also waiting for my fistula to heal so that they can go back to using it for dialysis. Thank you for your prayers, they are much appreciated. And, I am also very thankful for my wife. She provides me with physical and moral support on a daily basis. I do not know how I would be coping in all of this without her.


http://nmccart.blogspot.com/2005/12/perm-cath-placed.html
At 8:44 PM, Anonymous said...

I am 24 and have ESRD. I also have a catheter in my chest and have a fistula. I've had problems every dialysis session with the fistula, so I've been using the catheter for four months, which is how long I've been on dialysis. Good luck with everything.

For me, the dialysis in my fistula was going great (as far as I was concerned). My nephrologist was the one that said I needed to get it revised so that I could receive a better dialysis treatment. I am only hoping that once my fistula heals, it will work even better than before. I know that since this second surgery, I have been able to feel the thrill in my arm above my elbow, which is new for me. I do not enjoy my catheter, as it makes it hard to shower and to sleep. I imagine that they will leave it in for a while even after they start using my fistula, just so it will be there in case of any problems. Thank you for writing and for coming by to read my blog. I hope that my experiences have been helpful to you. Hopefully your dialysis will get better soon.


Okay, everyone, thank you for coming by to read today. I know that today’s post was a little longer than normal, but that just makes up for the last two posts which were really short. Thank you all for reading and for continuing to pray. Merry Christmas!! (though, I will probably post again between now and the 25th).

Perm-Cath: Placed

On Thursday, I was scheduled to have the temp-cath removed from my neck, and I was supposed to have a perm-cath placed in my chest. Let me just describe for you what went on Thursday (the story ends well, so don’t fret).

Last week, I was told that my procedure would begin at 8:00 am and that I would need to arrive at 6:00 am to be processed and prepared for the surgery. Now, as luck would have it, we had a huge cold front and almost no precipitation on Wednesday night, which caused all of the schools in the area to either close or to open late. I was told to base my decision on coming to the hospital per the local school district. So, if our town is closed, then the radiology department will not be open. I watched TV until 5:30, when we had to leave to get to the hospital. The school district was not listed, so we went. The roads had almost no ice on them at all, and driving was absolutely no problem. We listened to the radio on the way to the hospital, and they did not list the school as being closed.

We arrived at the hospital to find that the school district had been closed on our way there. But, since we had already arrived, they called radiology, and said we could go back and that they would take care of us. I got my paperwork completed and had an IV by 6:30. The doctor finally came to see us at 10:00. It seems there was some miscommunication between the nurse and the doctor, and our doctor was the only one that did not show up to work on time that day. So, there was a LOT of sitting that we had to do.

My procedure went great once we got started. They took me into radiology at about 10:30, and I think we were home by 1:30. They removed the temporary dialysis catheter from the right side of my neck. They just had to cut the stitches and pull it out, it wasn’t too painful. Then, they held the hole until it stopped bleeding so that they could patch it up. I then felt the knock-out juice going into my IV, and that was all I remembered. When I woke up, the entire right side of my chest hurt, and I now have two small tubes hanging out of the middle of the right side of my upper chest. They sent me home, and everything was great (especially since I finally got to eat).

I had dialysis Tuesday night using this new perm-cath, and it went great. The machine can not run quite as quickly as it can for a fistula, but it runs much better than with the temp-cath in my neck. The treatment went great as compared to last week. There were no problems with the machine the whole night.

About my only complaint at the moment is that the right side of my neck and chest are both hurting from the procedures yesterday. I did not sleep well last night (probably due to the pain). I am hoping that it will be better tonight. I don’t have to carry anything around at work, so I am hoping that the muscles will heal quickly and on their own. Oh, and another bonus, I can take showers again!

The doctor said that the site needs to have the bandages changed in three days and that I need to keep them on for at least 10 days. He said that the stitches could come out in six weeks and that it should be mostly healed by then. Apparently, the wound will form scar tissue around the catheter, which will help hold it in place more securely.

Thank you for all your prayers during my procedure. Right now, Jenny and I would like you to pray about my Saturday treatment time. Our church’s Christmas program is Saturday night, and I have to move my appointment in order to play in the program. Please pray that God will open up a slot for me somewhere so that we can participate in the Christmas program. Thanks!