Kidney-versary #4 (And Other News)

Guess what? I remembered that I have a blog! I'm sure you're all very excited. I look forward to my hit counter jumping by at least one point this week. I'm sorry that it's been a while since I have blogged, but I think my time has been concentrated elsewhere for the last year :)

Post-Transplant Lab: October 07, 2010

As you can see, I plan to break up this post into sections. At least then, you can scroll around a little and read what you feel is important (to you). I saw the doctor for my normal four-time-a-year appointment back in October. The last useful information I probably posted was about my cardiologist, but here we are back to nephrology. The doctors ran all of their standard tests. They came back with a 1.1 in creatinine (which was the same as it was on July 8, 2010). They do not worry about a creatinine until it is higher than 1.1. My BUN went up from 10.0 to 12.0 (the normal range is 7.0 - 21.0).

The other lab numbers looked pretty consistent. I'm happy to say that the regimen that I am on (diet, exercise, medication, and doctor care) have kept me in about the same place since my transplant. They also had me do a 24-hour urine collection before the appointment, and those results all looked pretty normal. All in all, the doctors said that I was in great health, and that I should come back in three months.

On a side note, I asked about chicken pox. At the time, Hannah was nearly one year old, and she was scheduled to have a live chicken pox vaccine between 12 and 18 months. The doctor said to avoid all bodily fluids from her for (I think) one week (maybe two weeks) after she has the vaccine. I'll ask Jenny, as she will remember how many weeks it is. It will be sad, once she has the vaccine, that I have to basically avoid her. (Babies are constantly producing bodily fluids of some kind).

Glofil Appointment and Labs from January 13, 2011

This brings me to the present. Hannah has not had her chicken pox vaccine, yet. I have not had to avoid her. Oh, and it's been kind of cold here in Texas. Also, I rode in a car for a total of four days with Jenny's family to go and see her relatives in Arizona. It was a good trip, and I think I did a good job of staying hydrated (except when we were in the car).

As the title of this section implies, I had my annual Glofil appointment on the 13th of January. If you are new to the blog, click on Glofil appointment for my short explanation of the test. The short answer is: you are in a lab for four hour, drinking water, collecting urine, and having blood drawn to measure kidney function.

I've always thought that this was the most accurate test that they can do for your kidney function. But, it seems that even this test can have errors. My Glofil results have been in the low to mid 80's since my transplant. My understanding is that a perfectly healthy person would have a score of 100 (perfect). When you are pre-transplant, they cannot put you on the transplant list until your Glofil is less than 20. Once you are less than 10, then they recommend starting dialysis. My score came up as a 71! This sounds bad, to me, but the doctors were not worried.

They ran the standard labs on me, as well. My creatinine was down to 1.0 (from 1.1 last time). My BUN was consistent at 12. I have an HDL (cholesterol) of 43.0 mg/dL (range is 21 to 74). My LDL is 69.0 mg/dL (range is 44 to 136). My cholesterol is 122.0 mg/dL (range is 0 to 201). My triglycerides were 120.0 mg/dL (range is 0 to 201).

The doctor seemed to think that the lower Glofil score was not consistent with the rest of my blood work from that day. She said that it may be something else was going on, or the test results were slightly off, or something happened (who knows?). So, she suggested that I do another 24-hour urine collection this weekend and return the results on Monday. That way, they can test the creatinine passed in the urine over the course of an entire day and see how that compares to my blood work and to the Glofil test. As long as the 24-hour collection and the blood work match up, then they will not worry about the odd Glofil score.

They also did my yearly bone density test at this appointment. They've updated their testing criteria and are not longer worried about the radioactive part of the Glofil test. The unofficial word is that my spine's number was slightly down, and my hip's number was about the same. I am still at the very edge of the osteopenia range (almost normal). She advised working out using weights or resistance to help push me up into the normal range. She also said that the spine fluctuates more than the hip, so the difference there was not unexpected.

I think that is about it for me for today. I have to do my collection and turn that in on Monday. I won't hear anything back from the doctors unless there is a problem. So, have a great day, and this is me, signing off for now.

See you all next time (when I hopefully remember to blog sooner after an appointment)!

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).

Follow-Up from Friday's Appointment

I went to the doctor again on Friday. They said that the CMV test results were negative. At least that is a positive thing.

They ran a sonogram on my transplanted kidney while I was there to see if there were any problems. The sonogram came up good, with nice blood flow running through the kidney. They said it looked like I was getting more fluid, which is a good thing.

My creatinine was still at 1.7 on Friday. The doctor's original call was to have me go to the hospital and be monitored over the weekend. But, given that I promised to take care of myself, they said I could go home, drink LOTS of clear fluids (soups, Gatorade, salty stuff, etc) and take Imodium if needed.

I took some Imodium at noon, but did not need any more yesterday. I actually ate some semi-substantial food for supper last night, which is a good thing. And, all the food stayed down (also good).

I woke up this morning feeling well again (which is nice). I ate some Cheerios and a banana for breakfast. Now, I just have to see how the rest of the weekend goes.

I have another appointment on Monday to see the nephrologists. Maybe they will be able to give me some good news. I hope I am still feeling better!

Thanks for all the prayers - talk to you again soon.

(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).

2009 Glofil Test and 2nd Kidneyversary

Greetings everyone!

I'm here to report on more great news. I had my 2009 Glofil test on Thursday, January 8, 2009. As far as I know, the results should be good (since they did not call to talk to me that afternoon). The test went very well. I had to drink seven glasses of water to start, and then only 4 glasses over the next three tests (one, then two, then one). The test was nice and easy. I made sure that I drank plenty of water for a few days before that. It really helps you with the test if you are well-hydrated.

I also saw the nephrologist while I was at the office. They were glad that I have been feeling well and did not have any changes for me. My creatinine was at 1.0 (which is wonderful). All of my other lab report numbers looked great. As always, my magnesium was a bit low. My sodium and chloride were also a bit low, but that's not a problem. The cardiologist had said that my triglycerides were a bit high and that I needed to watch them. According to the lab report from the transplant clinic, my triglycerides were at 201.0 mg/dL. The standard range is 32.0 to 238.0.

Sunday, January 11, 2009, will mark my second kidney-versary. I have been feeling great. Since my surgery on my nasal septum, I have not been ill. I have been feeling great and am loving my transplanted kidney. I am appreciative every day for the family that made the difficult choice to donate the organs of a loved one. I am thankful that they made that choice that has changed my life for the better.

In other news, it appears that there are people (in the world) that have found my blog interesting (and possibly slightly helpful). I received an e-mail this week from a guy named Micha. It appears that his wife has recently discovered that she, too, has polycystic kidney disease. It sounds like they are young and that she is not near kidney failure at this time (which is good). I'm glad to hear that my posts may have been encouraging to them. They are living in Zambia for a few years. If you would like to read their blog, it is at http://mccoy.wordpress.com/

Finally, I have also received a comment on the post "Many Tests Later" regarding my nasal septum surgery. The commenter asked about how my post-surgery recovery was and what was to be expected. I left another comment to hopefully help the commenter know that I have been doing well and was glad to have the surgery.

Thanks to all the readers that are out there. I'm hoping that you all have enjoyed your reading today. I know that I don't post all that often, but I have been doing great. Please feel free to continue to comment and I will keep doing what I do.

See you next time!

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!

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!

Tuesday's Clinic Appointment

Well, I went to the clinic on Tuesday (the 23rd). The doctor's office moved down the street a few blocks to remodel their building. It wasn't too bad, though it was smaller than their normal office. Hopefully the newly remodeled office will be nice and have a much larger waiting area when they get it remodeled.

I had to call to get my lab results, as they did not move the lab facility. My creatinine is still at 1.0. There were no problems on any more of my blood work or urinalysis. I noticed a little bit of blood in my urine on Friday night, but it wasn't that much. I think perhaps a cyst burst in my old PKD kidney, as it had been hurting some the past few days. I called the doctor, but they said just to stay well-hydrated and not to worry about it unless it got a lot worse.

Not too much else is going on. I have to sign up for the new insurance year at work in the next week or two. I will have to talk with our HR department, because Medicare is going to switch to being my primary insurance in April. I have to know what level of insurance to get if I am going to be on Medicare as the primary instead of United Healthcare.

See you all next time. I hope to have more information then.

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.

Answering Comment Questions (and more)

Good morning everyone! It has been almost two weeks since my last post. The good news is that there continues to be nothing wrong. I am feeling well, and am enjoying having energy and motivation to do all the work that a new house requires.

I received a comment on a previous blog post:
(http://nmccart.blogspot.com/2007/07/post-transplant-glofil-3.html)

The question comes from Bmaddny on July 25:
Hey, what was your creatinine prior to your transplant?

Well, Bmaddny, I'm glad you asked! That question can be answered in multiple parts. Way back in 2005, while I still had two kidneys that soft-of worked, my creatinine was between 2 and 4.0, depending on the month they were checking. Once my left kidney got infected and removed, my creatinine shot up to 6, and then I think even higher. By the time I was on dialysis, it was not unusual to see a creatinine of 9 or 10. So, depending on when in the past you were looking, I have had a multitude of creatinine levels. The 1.0 that I am getting now, post-transplant, is the best that it has ever been (since it has been tracked). I hope that helps!

(and more)
Well, the title hinted, and here it is! I finally scheduled my bone density scan for Monday, August 6, 2007 (in the afternoon). That way, the doctors will have three weeks to review the results prior to my next appointment. Then, they can tell me if I am doing better or worse than I was on January 25 (when I had my first-ever bone density scan).

Finally, a medication update. I do not recall when the last time I updated everyone was, so here is the current list:

• 9 am: Bactrim (400mg/80mg)
• 9 am: Calcium +D (600 mg)
• 9 am: Cerefolin (PAL/M5) (two)
  
• 9 am: Folic Acid (800mcg)
• 9 am: Myfortic (360mg)
• 9 am: Prednisone (10mg)
• 9 am: Prograf (5mg)

• 9 pm: Atenolol (25mg)
• 9 pm: Calcium +D (600mg)
• 9 pm: Fish Oil (1000mg)
• 9 pm: Lovastatin (20mg)
• 9 pm: Myfortic (360mg)
• 9 pm: Prograf (5mg)
• 9 pm: Zyrtec (10mg)

Have a great week everyone!!

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!

Couple of Quick Updates

Hey everyone!

It's been over a week, and it seems I have had nothing to say.

Our church had Vacation Bible School this week, and Jenny and I participated by being "park security." We had the event at a local water park. The only problem was the torrential downpour that occurred on Tuesday and Wednesday, which reduced us to two days of VBS instead of four. But, I think the program was a success overall.

In kidney news, I think all is going well. I am trying to keep myself well-hydrated. I stopped taking Nexium this week, and I do not think there have been any negative side effects. That will save me several dollars a month, so I am glad to be off another medication. I think the next medication I get to cut out is the Bactrim, but I won't know until after my next clinic visit in the middle of July.

Speaking of clinic visits, I still need to schedule another Glofil test. This will be my "six months post-transplant" workup, so it should be a good one. I am going to try and set that for the same day as my clinic, so I don't have to go down to the office twice.

I also need to remember to call my cardiologist next month and see if they have any other options for lowering my triglycerides other than the "tricor" that they wanted to put me on. The nephrologist said no because it could raise creatinine. I guess I'll have to make that call next week, too.

That's about it for today. Nothing much, but I am still doing well, so that's always good news! Enjoy your weekend.

Clinic and Cardiology Updates

Welcome to Wednesday! It's been a little over a week since I have sent out an update, so I figured I had let enough time elapse. I have a couple things to cover, so the post won't just be fluff.

I had a cardiologist check-up last week. The doctor said that I seemed fine and that she wanted some blood work (to check my cholesterol) and to get an echo of my heart to check on my mitral valve prolapse.

I had the echo cardiogram done on Monday afternoon. The technician was not able to tell me anything (of course). The doctor called on Tuesday to let me know that my prolapse looked about the same as it had six months ago, and I will need to get another echo in six more months. That was what I had hoped for, since it had gotten worse between the last two echoes I had had done. But there was not change on the latest echo (Monday) so I am in good shape for another six months. That means no valve replacement surgery for me (yet).

I also had my post-transplant follow-up clinic appointment on Tuesday (yesterday). My creatinine is still at 1.0, which is great!! The other numbers in my lab report all looked about normal, so that's good news, too. In fact, the doctor said that I was doing so well that I do not have to come back for a whole month! That's wonderful, since it means less time out of work to go to the doctor to hear that I am doing well. I'm also glad that the new kidney is working well enough to keep me out of the hospital or out of the doctor's office.

Coming up next will be another Glofil and another bone density scan. Those are both scheduled at the six-month after transplant mark. So, come July 11, I will need to get that on the books. I guess I should go ahead and schedule the Glofil soon, since I already have a doctor's visit set up for July. That will keep me from having to go down there twice.

That's it for today! Stay tuned next time for more fun kidney information (or not fun, I guess it depends on what you enjoy).

Glofil Results and More

Welcome everyone! I realize that is has been two weeks since my last posting, and I apologize. Not much has been going on, medically, so I haven't had too much to say.

I went to the clinic today for my standard follow-up appointment. I opted for the Tuesday appointments, since Monday was so terribly busy the last time I went. I left work at 10:00 to be at the clinic by 10:40, and was back at work by 12:00, so that's not too bad. I think I'll stick with Tuesdays for a while.

I got back my Glofil results from my last visit. My Glofil is 82. You may remember last time that my Glofil was 86.1. The doctor said that 82 is wonderful and that I have nothing to worry about. I just need to keep drinking my water and taking my medications.

I told the doctor that I felt like I had been sweating more since my transplant. He said that many patients complain of the same thing and of oily skin. He said that if it gets to be a real problem, I will have to talk to a dermatologist. I don't feel like it is a problem, yet, it was just different than before my transplant.

I also got back my lab results for today. My creatinine is at 1.0, which is wonderful. My cholesterol is a little higher than it was last time, but still within the normal range. The only number that was out of range was sodium, and it was just a little low (132.8 with the range being 136 - 144). Aside from that, all of my numbers look like they have been. Magnesium continues to be slightly low, but it is not causing any concern.

In non-kidney related news, Jenny and I have officially moved in to our new house. (Well, new to us). We spent the three-day weekend (and the entire week before) unboxing and sorting things where we want them to go. All I have to do now is to figure out how to clean out the dryer's external exhaust vent so that the dryer will work better. We just installed door stops to keep from punching doorknob shaped holes into all the walls. It's going to be a lot of work, but I am glad to get in to a new place.

See you next time. Hopefully it will be sooner than the 3 weeks away for my next appointment. That's right, the doctor said I don't have to come back for 3 weeks! Yippie!

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!!

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!