(251) Nathan Gets Tested for CMV

Hello everyone! I'm writing today to let everyone in on what has been going on with me for the past week, and what they think is happening.

The title is sort-of a spoiler. The week has ended with me being tested for CMV. You can read all about this on the Internet, if you like. It sounds like it is a standard virus that more than 50% of adults contract in their life time. It's really not harmful, unless you have a suppressed immune system (like I do). They did the test today, and I should find out an answer on Friday.

Okay, now to rewind. I woke up late last Wednesday night (early Thursday morning) feeling nauseated. My stomach was sour and I kept having diarrhea through the night. I did not go to work on Thursday, and had a couple of vomiting spells. I cut back, and only took my transplant medications on Friday, and did not vomit any. I stayed home from work that day, too. I felt bad on Saturday and was slightly better on Sunday. I went to church Sunday and it was not terrible. I needed to rest during the day, which was good. I went in to work on Monday, but did not feel great. The diarrhea was gone on Sunday but back on Monday.

Tuesday morning (yesterday) I was sick again. I was throwing up and the diarrhea was back in full force. I stayed home Tuesday (and today). I went to the transplant doctor's office Wednesday (today) to see if they had any suggestions. They told me that I was dehydrated and had lost ten pounds. Those two items helped contribute me to having a creatinine of 1.7 (which is bad).

The doctor gave me one liter of saline and sent me to have a CMV test done at the nearby hospital. I guess they don't have the equipment to do that at the transplant office. And, it was a good way to cost me $2 for parking. I go back to the office on Friday to get my results from the CMV test (and see if they found anything).

So, in summary, I've been sick for seven days now. It's not fun, and I'm not enjoying it. I don't know what to do to get better, and the doctors don't have much information to give me, yet. I'd appreciate any prayers.

I'll give more updates when I learn more (probably after Friday's appointment).

Thanks!

Follow-Up From Appointments

I went in for my cardiologist's appointment and ran on the treadmill. I walked/ran for a little more than ten minutes to get my heart rate up over 161. The technician put me on the table and then looked at my heart and the pulmonary vein. She mentioned, during my test, that I was doing really well and that she did not expect to see anything wrong with my heart. The doctor, after reading the test results, told me that my heard and pulmonary vein were working just like they are supposed to be. This is great news! Based on what the doctor told me last time, it's likely that I am just noticing more how my heart and breathing are rather than they are getting worse.

So, there is nothing (else) wrong with my heart. I've still got mitral valve prolapse. My heart still has a moderate to severe prolapse. One day, I will probably need to have a valve replaced, if my heart continues to work the way that it does. But, there are no problems coming my way any time soon.

I also had a nephrology appointment this week. This was my regular quarterly appointment. The doctor was very pleased with the results of my 24-hour urine collection. She said that I had my best results on that test since my transplant. My labs were also great. My cholesterol looked wonderful (HDL was 43.0 and LDL was 69.0). This is great news, saying that my medication is still at the right levels. My creatinine stayed at 1.0 (great news) and they were glad to see me again.

I will be going back in about three months. I'm glad my kidney continues to function just as well. Stay tuned for more news as it comes up. I had a fever last week of 100 (for just a morning). I felt hot, but it was much better by lunch.

My cystoscopy results were great. The urologist called back while Jenny and I were getting her 20-week ultrasound. They said that my urine did not have any signs of cancer. So, that's more good news. I guess the problem that I had had with my urine a couple of weeks ago was all related to my natural polycystic kidney.

Thanks for reading. I'm glad to continue doing well with the transplant.

And remember, you can always follow me on Twitter for updates (other than the blog).

(246) Monday Misadventures and a Pending Cystoscopy

So, I probably should have tried and blog about this yesterday, but I didn't take the time to do it. I wanted to let everyone know, for starters, that I am still okay and as of yet, nothing has been deemed wrong with me.

Sunday morning, I noticed some blood in my urine and some particulate as well. The particulate was small pieces that seemed fleshy. This was a bit disconcerting, but there was no pain associated with it. I had a lot of water to drink that morning (since church was starting at 10:50 instead of 9:15 that day). Going to the bathroom two more times, I still saw particulate, but the color was less red each time.

When we got home from church, I went to the bathroom again, and saw that the color seemed normal and that there was no particulate. I called the 24-hour doctor's line at the nephrologist's office, and they paged the on call physician. We talked and he said that if there was no pain that I could just go in to the clinic on Monday to be checked.

Monday, I saw the doctors. They ran blood work and everything was normal. My creatinine was at 1.0 (good) and the other results were normal as well. They also ran a sonogram on both of my kidneys (the native and the transplanted). The sonogram showed nothing abnormal on either kidney. The doctors suggested that I should have a cystoscopy done by my urologist.

I called the urologist and set up an appointment for Friday. I'm not sure if he will do the procedure in his office that day or if he will evaluate me and then set up a date for the cystoscopy. My understanding is that it can be performed in the office, depending on the "type" of test they do. The point of the cystoscopy will be to see if there is a kidney stone in my bladder. Those interested can read more here: http://en.wikipedia.org/wiki/Cystoscopy.

Please pray that the test, if needed, goes well and that this was only a burst cyst in my native kidney (or something else that was non-problematic). I'm not worried, but I would prefer if there was nothing wrong (especially with the transplanted kidney).

Thanks for reading and praying! See you next time.

Post-Transplant Clinic: April 2, 2009

I had another quarterly post-transplant appointment with the Dallas Transplant Institute in lovely downtown Dallas, TX. Once again, it seems that I am doing well.

Here are my results (of note):

• Creatinine is at 1.0 (same as last time) -- this is still GREAT
• BUN is at 12.0 (up from 11.0 last time) -- this is GREAT
• Triglycerides were at 253.0 (which is bad, but I also had donuts for breakfast)
• Cholesterol was at 141.0 (which is actually low, oddly, compared to my triglycerides)

The doctor asked me why I had eaten donuts before coming in for blood work. I told them that if they want me to do fasting labs that I will NOT be scheduling them at 10:30 am (meaning get blood drawn between 10:30 and 11:00). As it turns out, they want to do an accurate check, so I'm supposed to have a fasting lab done next time, and I scheduled my next appointment for 7:40 am.

They also told me that I need to have a sonogram done of my "native" kidney. Your native kidneys are the ones with which you are born. In my case, since I had my left one surgically removed, I have only one native kidney left, and it is on the right side. The doctor reminded me to tell the technician that so that they don't spend thirty minutes looking for a kidney on the left that isn't there.

Additionally, I have not done a 24-hour urine test in over a year. So, they gave me a few buckets to fill up. I'll probably do that some Saturday here in the near future and drive those buckets down to the transplant clinic early on a Monday morning. I figure that as long as I get the 24-hour urine test back to the doctors WAY before my next appointment, they can tell me if there are any problems when I see them (or call if there are SUPER problems).

Neither of the procedures listed above are any problem to do. The sonogram is in the office and will just be at my next appointment time. The 24-hour urine collection is done at home. The only negative part of that is keeping a SEALED container of urine in your refrigerator all weekend. Granted, that's not a problem for us as we have no children or any guests staying with us, but I have that it can be an issue in other households.

All is well with me. My weight continues to fluctuate around 185 lbs. My height stays steady at 6-feet and 2-inches. So, I'm not really overweight, though I feel that way some times. I think my residual self-image has me still being around 170 lbs (which is small). I doubt I would ever be that, no matter how much I exercise or diet.

Speaking of which, I am working on my exercise. I try to walk on my treadmill at least once a week. I try to take the stairs at work (to the third floor) every day. And, with diet, I just eat what Jenny feeds me, so there's not much worry there.

Thanks for reading. I know that I don't update all that often, but whenever I received e-mailed questions, I try to answer them right away. See you all next time (around the end of July).

Happy Birthday to Me!

Well, March 18 is my birthday. I am now a thirty year old man with a new (to me) kidney. If it is one year old, then does that make my average age 15?

I'm actually posting this in mid-April (the 21st). I fell behind in my blog postings, and I wanted to get this information on line prior to making any new posts. It's just your normal "lab report" plus a little bit of non-kidney news at the end.

My lab appointment this time was at 7:30 am. I think that may be the reason that my creatinine was up to 1.2. It has been 1.0 since my transplant, but I normally see the doctor later in the day. I don't think I had enough time to drink a lot of water before my urine test, so there may have been a little more junk in there than normal. My next appointment (May 13) will also be at 7:30. I'm going to try and see if I can drink at least 20 ounces before I leave home that morning. Perhaps that will help with my creatinine.

All my other lab numbers looked pretty good, and pretty similar to last time. My BUN was still at 14.0 mg/dL. My magnesium remains a bit low, at 1.6 mg/dl (on a normal range of 1.7 - 2.1). Everything else looked great.

I also had my one year bone density scan done. It sounds like I am pretty close to the same place I was six months ago, which is pretty good. The only change the technician offered was that I should exercise with some weights, just to add some resistance to my bones to cause them to be a little stronger.

Aside from that, I'm doing pretty good. I don't have to go see the doctor again for eight weeks, which is nice.

Here's the news I mentioned earlier:
Jenny and I are now working towards adopting a child!

Rather than bore the kidney-only readers with information about our adoption process, I have set up a new blog. You can find it at: http://nmccart-adoption.blogspot.com/

Have a great week, and see you all next time!

11 Months Later: The Transplanted Kidney Works Great!

Well, it has now been a little over 11 months (not since I last posted, silly) since I had my kidney transplant. I have to say that everything is going great. I went to my regular post-transplant clinic this week and the doctor said that I am doing great.

My creatinine remains at 1.0. My BUN is still 12.0 (which is good). Sodium, potassium, glucose, phosphorus, and all the other chemicals look great, too. The only thing that is "out of normal" is my magnesium, and it has been slightly low ever since the transplant, so I do not think that they are worried about it too much.

I have my one-year Glofil test scheduled in January. If the results are normal, the doctor said that I will only have to go back for a Glofil every January (which is nice). The Glofil is always at least a half-day appointment, so it will be good from a time management standpoint to not have as many of those.

I had a renal sonogram while I was in the office on Tuesday. The doctor wanted to make sure that my old Polycystic Kidney is not in there causing any problems. The technician obviously could not tell me anything that she saw, but she let me look at the kidney and it looked just as gross as ever. She also showed me the new kidney, which was just perfect looking. It had that great kidney shape, and obviously is doing it's job quite well.

In medication news, I am slowly working down my prednisone dosage. I had been on 10 mg for several months, and since I am almost at my one-year anniversary, I asked (last time) to get on a lower dosage. So, the doctor said to drop my dosage one milligram per month. I am on my third week of 8 mg, so I'll be down to 5 mg by the end of February (I think). I have not started noticing any of the side effects, like always having the "munchies", going away yet. Maybe that won't be noticeable until I have been on 5 mg for a while.

I also saw my cardiologist on Tuesday. She wants to get another echo of my heart to make sure the my mitral valve prolapse is not getting any worse. She said that it still sounds good, but she still wants to take a look to make sure. She also increased my dosage of atenolol (for high blood pressure) from 25 mg a day to 50 mg a day. I just started that, so I don't know the full effects yet. She said it is possible that I will become dizzy, so I am watching out.

Work has been extra-super-crazy for the past month or so. The company is doing a giant software upgrade on some of its internal systems, and I have been deeply involved in End User Acceptance Testing. This is taking several hours a day every day, and has not quite come to an end yet. I am hoping that we will be done before Christmas. I really don't want to keep working on this project next year (for 3 or 6 more months). At that rate, it will be time to upgrade again before this upgrade is completed.

Other than that, not much else is going on. I played my violin in a couple of Christmas concerts, and that was fun. It's been cold and rainy in Texas (but not freezing cold, just 40's cold).

I have that echo on my heart scheduled in the next week or two, so I'll let everyone know what's going on then. Until later, have fun, and enjoy your Christmas!

Doctor's Visit - 08/28/2007

I had my regular follow-up clinic visit on Tuesday. The doctor said that I was doing well, and that my lab reports all looked good. My creatinine remains at 1.0. My magnesium is up from 1.1 to 1.6. A normal magnesium is 1.7 to 2.1, so I guess that is good. The rest of my numbers looked about like I have expected them to. My White Blood Cell count is at 7.3, which is always nice.

The doctor said my bone density test was similar to the first one they gave me. I scored exactly the same on my lumbar region (spine). I actually got a slightly higher score on my hip bone, which I guess is good. That means that my exercise and calcium supplements have been working. Speaking of exercise, I got back to doing that this week. I got my ID badge at worked coded so that I could use the fitness facility we own. It's about 15 minutes away from work, so I'll try to go there two to three times a week and get some walking done.

I talked to the actual doctor about the Glofil problem that I mentioned last time in the blog. My score has gone down about 10 points since the first test after the transplant. The doctor said she didn't know what exactly was wrong, or if it was even a problem. She asked me to do a 24-hour urine test to make sure my clearance was still good.

I'll have to see how I am doing the next time I go in. But, the doctor doesn't seem worried. She didn't need me to come back for eight more weeks.

See you all later! Enjoy your Labor Day weekend. I know I will. My mom is coming in town to see the new house. Should be loads of fun.

Post-Transplant Glofil #3

Good Morning! (And, if I don't see you, good afternoon, good evening, and good night).

Tuesday, the 17th, was my 6-months Post-Transplant Glofil appointment. As always, if you are unfamiliar with the Glofil test, you can read about it in a previous post here: http://nmccart.blogspot.com/2007/02/upcoming-first-post-transplant-glofil.html

My score this time was 76.3. That is down from the last two scores. On 2/22, I got 86.1 and on 5/14, I got 82.0. I spoke with the nurse at Dallas Transplant Institute this morning, and she said that this is not a problem. Since my creatinine is stable and my urine output is stable, then there are no worries. Speaking of that, they ran labs on Tuesday as well, and my creatinine remains at 1.0 (which is wonderful). The next Glofil comes 9 months after my transplant date, which should be around October 11, 2007.

And ... while we are talking about lab reports ... the only problem the doctor pointed out on my lab report was that my triglycerides are pretty high. The acceptable range is 32.0 to 238.0 mg/dL. On 6/19, my triglycerides were at 175.0. But, yesterday, my triglycerides were up to 281.0. The cardiologist had previously complained that my triglycerides were too high, so now I need to work with the two doctors to get on some medication to get that down. The transplant doctor suggested that I might could take Fish Oil supplements, if the cardiologist will approve. I am going to send my lab reports to the cardiologist to see what dosage of fish oil that they suggest in my case.

The only thing left to schedule for the transplant clinic will be a Bone Density test. It seems that they cannot do the bone density and the Glofil at the same time, due to the Glofil using a radioactive dye that would interfere with the bone density. The bone density test is pretty quick, so I will see if I can get one scheduled for some morning soon (they want it done this month).

So, that's all for today. Maybe I'll find out what the cardiologist wants so I can get my cholesterol down. Have a great day!

Another Quick Update

I thought of some more things to say after I posted yesterday. So, I decided to go with a "bonus supplemental post" for today.

First of all, I want to say that I have enjoyed being back at work for the past month. The only problem is that everyone here is attempting to kill me. I work in a cubicle, surrounded by cubicles. The loudest sound I hear is coughing all around me. Don't these people know that I have a suppressed immune system? I am easily susceptible to all sorts of diseases. So, despite my enjoyment of work, I have to try and avoid contact with anyone that is in my area. That way, I can stay healthy. It has worked, so far. We shall see how long that lasts.

The other news I have is good news. After I had my blood drawn at the clinic yesterday, I went back to sit in the waiting area to have my name called to see the doctor. While I was sitting there, I saw a familiar face heading to check out. One of the women that was on dialysis at the clinic while I was on dialysis was leaving. I went an talked to her, and it seems that she had just received a kidney and pancreas transplant. She is blind (or mostly blind) and her son was with her. I recognized the two of them leaving. I was glad to hear that she had gotten a transplant and was doing well. I believe she said she got transplanted about a month ago.

So, good news for the lady from dialysis, and bad news for me if everyone at work keeps being sick. Maybe once all the rain slows down they will start feeling better. I haven't gotten sick yet, and that's good.

See you all next time.

Clinic Visit from Monday

Hi Everybody! (Hi, Dr. Nick)

I had another follow-up appointment yesterday (I am now seeing the doctors every two weeks, which is nice). They scheduled my 3-month Glofil test on the same day, so I was in the office about three hours or so.

The Glofil test was nice and easy. I think that I must be keeping myself fairly well-hydrated on a regular basis. I did not drink much more than normal during the weekend. When I arrived at my test, I was told to drink 5 glasses (about 200ml each) to start. Then, the second round was 1 glass, and I drank 2 glasses for the third and four rounds. I feel like I was better off than the guy that had to drink 3 to 5 glasses each time. I took the test in the morning, and the lab guy was not available after my doctor's visit, so I probably will not find out my results until the 29th, when I return to the doctor's office for my next clinic visit.

In other news, my creatinine was down 0.9 (from 1.0 last time). It is always good to see my creatinine down, and I am pleased any time it is below 1.0 (which is very good). This means that my new kidney is functioning well after about four months of living in my body.

They drew my cholesterol and everything looked good. I think I will be able to stay on the Lovastatin instead of the Lipitor (saving a bunch of money every month).

I think that the Myfortic is much more gentle on my system than was the Cellcept. I can't tell for sure, since I am taking an antibiotic for some "other" GI issues. I will stay on two Myfortic per day for the next two weeks and see. If I'm doing okay, maybe I'll ask the doctor to raise me to three per day.

I am almost done taking the antibiotics from the GI doctor. I don't know if they are working or not. I guess they will have to do another study to find out. Luckily, I won't have to take any more after Wednesday. I do not like the taste, and I do not think my intestines enjoy them, either.

I think that's it from a health standpoint. We got the carpet and tiles in the new house cleaned by Dalworth, and they did a great job (I was there when they finished up, and it looks very nice). They told us how to seal the grout and how to Scotch-Guard the carpet to help protect both, and we will probably try and do that this week before the furniture arrives. Dalworth also came out (different crew) to clean all of the air vents, ducts, and returns. They even fixed the slight rattle that our air conditioner was having. It seems the compressor was slightly unstable. I am hoping that that lack of dust and dirt will be nice on my allergies for at least a couple of months until our dust fills up the house. Oh, and Dalworth sent me a coupon code which is good for six months, so if you are having some services done, let me know, and I'll forward you the code.

That's about it. My health is wonderful, and the house is nice and clean. I do not plan to do do too much moving, to keep myself safe and healthy. I had some pain in my old kidney after we boxed up some of our stuff, so I am trying to keep my stress levels down.

If I hear from the Dallas Transplant Institute before the 29th, then I will let you know what my Glofil score was. If you remember from last time, my Glofil was 86.1. I am hoping that it will be that good or better this time.

See you later!!

Post-Transplant Glofil Test #2 - MONDAY

Hello everyone!

On Monday, I have to take my second post-transplant Glofil test. For those of you unfamiliar with the test, I wrote about it previously here: http://nmccart.blogspot.com/2007/02/upcoming-first-post-transplant-glofil.html

I am going to be drinking a lot of water this weekend. It should be a lot of fun. I will also have my regular clinic (blood work) and doctor's follow-up on Monday, so I should see how my medicine is doing.

In other news, we have closed on our house, and we now have a set of keys. We still have some things to take care of before we move in, like getting the carpet cleaned, but I think we are ready. It will be a big adventure!

I'll let everyone know how Monday's stuff goes later next week. Until then, enjoy your weekend.

Monday's Clinic Appointment

I went to the clinic yesterday. My appointment was at 10:40, so I left work at 10:00. It seems that Monday is not the best day to go in. I did not get back to work until about 1:00. I think for any future follow-up appointments, I will stick with Tuesday or Thursday. I guess all the new patients go in on Mondays, so they get pretty backed up.

My blood work all looked very good. My creatinine is still at 1.0. My magnesium is up from 1.6 to 1.7. The doctor said my sodium bicarbonate level was up (closer to normal) so the doctor said that I only need to take one tablet per day instead of two.

I also switched from taking two 250mg Cellcept tablets per day to taking two 360mg Myfortic tablets per day. I want to have the higher dosage of protection from the anti-rejection medication. I tried it before, but for only about 4 days (and taking three tablets per day). This time, I am going to go with two tablets per day and try it for two weeks. That should give my body (and digestive system) time to adjust to the new medication and see if I still have problems at the end of that time.

The only other medication change was from Lipitor to Lovastatin for my cholesterol medication. The Lovastatin is available at a significant discount from Wal-Mart, so I am trying to save money. I asked the doctor to schedule a cholesterol test for my next appointment so that I can see if the new medication is working correctly. I will probably have them test it again two weeks later just to make sure.

The other suggestion the doctor made for my GI issues was to stop the Nexium. I told her that I'd like to try the Myfortic first, and if there is no change, then to try stopping the Nexium. Any time I can take less medicine, I am happy. Speaking of which, I think I will stop taking my Lunesta this weekend. I am on 10mg of Prednisone now, and that should be the lowest dosage for at least a year. The doctor said I could stop the Lunesta whenever I felt comfortable, so I think I'll try that this weekend.

The doctor also scheduled me for a second Glofil test for May 14. I know that is a Monday, but since it is a Glofil procedure, I have to be there half the day anyway. So, I will be drinking a ton of water that weekend in preparation.

That weekend is also when we will be closing on our new house! We have all the plans in the works, and just need to sign the paperwork on the 9th to be completed. It is very exciting to be moving into a new house. I just set up the carpet and vent cleaning today, to help get rid of some of the mold and dust in the house. Maybe that will be good for my allergies.

Well, I think that's it for this week. Thanks for all your prayers. Enjoy your week!!

Friday Update - April 13

Today is Friday, April 13, 2007. I had another clinical follow-up appointment (post transplant) today, and I thought I'd share how everything went.

First of all, I saw the "real" doctor today! The clinic is staffed by several physicians and physicians assistants. The team is headed up by a single doctor who reviews all of the work done for all of the patients each day (with his team). It seems, after my visit today, that he also sees patients himself. Today, instead of seeing an assistant, I got to see the head doctor, and that's always fun.

I told the doctor about the pain I was having in my side over the kidney incision. He said that if it did not get worse or if it continued for several days, then I should worry about it. He said that it just hurting for one day was not a problem. It could have been strained exercising or something like that, and I should not worry about it.

He got my lab results, and my creatinine is still 1.0! That means that drinking all of the extra water is helping, and my medication seem to be working. None of my other numbers seemed out of whack. The "liver numbers" all looked good, and my white blood cell count was still normal (which is nice to hear). The only blemishes I saw on the report were low sodium (never a real problem) and low magnesium (which has been slightly low since transplant). The doctor was not worried about either number. Sodium is especially easy to fix, and might have been low just because of the amount of water I've been drinking.

So, I'm healthy and happy. I got a note from the doctor saying that I could return to work full-time starting on Monday, April 30. And, I scheduled my next doctor's appointment for that day, too, so I can see how everything goes with timing my appointments with working and not using up all of my sick time. I scheduled the next appointment around lunch time hoping to use my hour up for that (we shall see).

The only other thing coming up is the colonoscopy and the endoscopy, which are set for April 23. Nothing for me to do for those until the 22nd, so no worries. Thank you all for the prayers as I continue to recover. Stay tuned next time for more exciting news from the kidney world!

Friday Updates

Welcome to Good Friday everyone. For me, I suppose it was a pretty good Friday. I had a lab appointment today, and I saw my GI doctor as well. My creatinine was at 1.0 today, which is a good sign. I think that I have been drinking enough water, which is good for me. I think that has been the most help at keeping my labs stable.

I saw the doctor at the clinic today. They said that they want me to reduce my Cellcept down to 250mg twice a day (instead of 3 times a day) to help reduce diarrhea. They also called this afternoon to have me increase my Prograf from 2.5 mg twice a day to 3.5 mg twice a day. I guess my Prograf numbers were really low, because they asked if I had skipped a dose (which I had not). So, I will take more of that for at least a week (until they draw labs next Friday). Then, we will see if the numbers are better balanced (hopefully).

I saw the GI doctor today as well. She said that she wants to check for any intestinal infections that might be hiding inside. Since I have a reduced immune system, I am at a greater risk of getting infections (even smaller ones that would not hurt most people). So, the doctor wants to do an endoscopy and a colonoscopy on April 23. She decided to do both procedures at the same time, since I would already be knocked out. She said she will take a look around, and possible take some biopsies if there is not anything to see.

Please pray that I will stay well. Pray that God will continue to watch over me and will help me stay healthy. I am still drinking lots of water, and I will keep doing so. It gets easier to drink more as you get used to drinking more water. Thank you all for coming by to read today.

PS - Jenny really wanted me to update the blog just now, so you can thank her that it got done today rather than tomorrow.

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 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.

Thanks!

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.)

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:

PROCEDURE	RESULT	UNIT	REF RANGE
[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
[Profile: PHOSPHORUS]
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!

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!