oops

You know, I totally forgot to follow up on my nine-day illness. I did get better.

After reading some comments on my previous post, I realized that I did not tell my reading community about the resolution of my problem.

It turns out that I got better soon after I last visited the doctor. I was sick for a grand total of nine days, and eventually got better. It was strange to be sick for so long after not being ill at all for the past two years. I'm glad that I am feeling better and that the doctors were there to take care of me.

Hopefully, I will not be sick again for at least two more years. I am doubtful of that, especially considering a new family addition that should take place in a few weeks.

My next task at the doctor's office will be to ask how infant immunizations affect an immuno-suppressed person (such as myself). I know that some of the vaccinations are live virus, and I need to know if it will be a problem.

I probably won't find out about that stuff until January. I'll post again (later) if I learn more. Have a great one!!

Post Op II - ENT

I had my second (and it seems, final) post operative appointment with the ENT on Tuesday this week.  He peered deep into my nose (after allowing me an hour to catch up on my reading in the waiting room) and said that I am healing quite well.  He said I should continue to use nasal spray and that the swelling was healing nicely.

I'm still blowing up a bit of dired up goop in my nose from time to time, but not very often.  My teeth almost never hurt anymore when I blow my nose, and it doens't feel all "crazy" on my septum when breathing in sharply or blowing my nose. (see http://nmccart.blogspot.com/2008/08/nasal-surgery-no-more-nose-splints.html)

My nose runs a bit still, but that's to be expected as I am allergic to all things in the air. (see: http://nmccart.blogspot.com/2008/05/allergy-test-results.html)  I'm glad that there is very little pain in sneezing or blowing my nose, though it is still sensitive to the touch (it hurts some).

That's about it for my nasal experience.  Oh, wait -- I don't have that persistent cough any more!!!  I guess that makes it all about worth it as far as the surgery is concerned.

Thanks for all of your prayers through this time.  I appreciate it, and I know God listened and helped make the healing go that much faster and easier.

Nasal Surgery - No More Nose Splints

Good evening everyone (and, if I didn't see you, good morning and good afternoon).

I had my first post-operative appointment from my Nasal Septal Reconstruction. I arrived at 3:40 for my 3:45 appointment, and was sent back to the room at 4:45. The doctor came in shortly thereafter and said that it would be a quick procedure.

He gave me some tissues to use to blow my nose when he finished. He said that the splints were being held in place my a stitch. He said he had to cut the stitch (not me) and then pull out each of the splints. Cutting out the stitch was not all that enjoyable, but I did like him removing the splint. It made my sneeze and my eyes watered, but I was able to breathe much easier. Then, he quickly removed the splint on the right-hand side. There was a lot of coughing, then I got to blow my nose.

Blowing your nose may not seem like a big deal, but you have to think about what I've been doing all week. I'm allergic to just about anything in the air, so my nose has been running (a lot) since last Monday. And, I wasn't allowed to blow it (shucks). So, getting to get some of that built up mucus (and dried blood) out of my nose was very nice.

It feels cold inside my nose when I breathe, at the moment. Also, if I blow too hard or inhale to sharply, then my septum feels as if it is flapping all over the place. Imagine holding a sheet of paper between your thumb and finger, one hand at the top of the page and one at the bottom. Then, turn the paper so that you are facing the edge that you are not holding. Blow sharply across it, and that's the the way my septum feels (or, that's the way I would describe it).

I don't have any worries. The doctor said that I am healing very well and he will see me in two weeks. He also said the slight numbness behind my two front teeth will get start to get better now. All I have to do is use some saline solution a couple of times a day for a while as my septum heals. They don't want my nose to get dried out.

Thank you all for your prayers for a quick recovery.

For those of you wondering: my next appointment with the nephrologist is September 11. So, you can expect an update on the kidney front after that time.

Surgery Complete

Surgery went well. Nathan is at home resting and surprisingly not in TONS of pain. The surgeon said there were lots of polyps in his nose and once he's completely recovered he should breathe a lot easier. Today was a very long day because everything goes slowly at the hospital. Yesterday, the anesthesiologist called and said that surgery would be at 11:00 instead of 8:30 like pre-admitting told us. So, we got to the hospital at 9:00 and Nathan was finally rolled back to the operating room at 12:15. He spent 2 1/2 hours in stage one recovery before they moved him to the 2nd recovery room where I could be with him. All this to say it was a long and tiring day, but things went well and we're glad to be home.

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!!

Test Results

I received my test results from the colonoscopy and EGD yesterday. There are nine pictures of what looks like it could be the inside of anyone's GI area. There is nothing of note in any of the pictures (and, I don't have a scanner, so I can't scan them to show them off).

Here are the remainder of the results (the text portion):

We performed a colonoscopy and an EGD today based on the following indications:

• Diarrhea, functional (C)

During the procedure we found the following:

• No duodenitis, ulcers, masses, or polyps seen. Duodenal aspirate was sent for analysis for infectious organisms. (biopsy)
• Erythema and nodularity in the antrum and stomach body compatible with gastrits
• The upper third, middle third, and lower third of the esophagus was normal. The EG junction was normal. No esophagitis, cancer, ulcers, varicose veins, or Barrett's esophagus seen.
• The terminal ileum was normal without any ulcerations, stricture, inflammation, masses, or polyps. (biopsy)
• Mucosa throughout the colon is normal. No masses, no polyps, no colitis, and no ulcers were noted. Vascular pattern is normal. Haustral folds are normal. Stool was sent for analysis for infectious organisms. (biopsy)

Our recommendations are as follows:

• Await biopsy results.
• I suspect the diarrhea is medication related.

The rest of the sheet is instructions to follow once I get home (which was yesterday).

So, now you see that I am perfectly normal (as far as they can tell from the inside). My colon and esophagus are just like they should be, and my problems might be caused by the Cellcept.

So, that's all I know. Oh, that and I have to have a release from the transplant doctor before I can see the dentist. I didn't know that earlier, but I do now. I'll talk to the doctor on Monday and see if I can get a release to get my teeth cleaned (was supposed to do it in January, but got a transplant instead).

Have a great day!

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!

Some Pain Today

Hi everyone. Thanks for reading the blog today. I just wanted to make a quick update for today.

This morning, I noticed that I have some minor pain over my transplant site. I noticed it after exercising this morning. I have been riding the exercise bike for the past several days instead of walking on the treadmill because my foot has been hurting a little bit. I think I slightly injured my foot a bit walking on it funny. But, I have been riding the exercise bike recently, and my foot is feeling much better.

Unfortunately, I also noticed some pain over my kidney transplant today as well. I am not too worried since the pain is minor, but I do plan to tell the doctor tomorrow when I go in for my clinic visit. Since I have a standard follow-up tomorrow, I am not going to worry about calling the doctor today. The pain is minor, so I am not worried.

I would like to have everyone pray for me, though. I would ask that you pray that the pain that I am feeling is not a problem and that the doctors will not be worried. I am glad that I have frequent appointments for just this reason.

And, I have my colonoscopy and endoscopy scheduled for April 23. I was reading the instructions for the preparation today, and I don't think I will be going to church on the 22nd. The preparation is fairly intensive, and is supposed to start at 7:00 am and go for six or eight hours. So, from the sounds of the prep sheet, I will need to stay at home all day. I think the worst part is that I am only allowed to drink (no food) for that Saturday and Sunday. Hopefully, the tests on the 23rd will not show any problems.

Thanks for coming by to read today!

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!

Monday - How I am Doing

Welcome back to the blog everyone. I am proud to say that I am (according to the doctor) doing much better today than I was on Thursday of last week. Now, I say that because I have not felt any worse since I had my transplant in January. I have been feeling great, and I continue to feel wonderful as time goes on.

The problem I was having was with my creatinine. It had shot up from 1.1 to 1.4 (which is bad). The doctor was worried that I might be getting dehydrated. So, we stopped one of my immuno-suppressants (the Cellcept) for the weekend to see if that would help. My creatinine went down, so my body is obviously not a big fan of the Cellcept. The doctor prescribed me a lower dosage pill (250mg instead of 500mg) and wants me to start taking two per day on Thursday.

I originally was taking 4 (500mg) Cellcept per day, after my transplant. The doctor quickly switched me to 3 per day after he realized that four per day was making me sick. The new doctor wants to try to ease me back on the the Cellcept, and said I need to make sure to drink at least two liters of water per day with it. So, I will attempt to be better with my water drinking, and hopefully, I will see better results when I go back to see the doctor on Friday!

So, my creatinine was 1.1 today (which is better). The rest of my lab results seemed unremarkable, so I will not bother you with them. Needless to say, I think that all is well and that I will try to enjoy the lower dosage of my medication on Thursday.

I'll talk to you all again on Friday, after I have another doctor's visit.

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.)

Thursday - Not so Good Today

I just got a call from the Dallas Transplant Institute. They said that my creatinine is up to 1.4 (which is bad). The lady said that I need to come in the the office tomorrow to find out what is wrong. She advised that I make sure that I am well-hydrated for the rest of the day.

They just ran lab work this morning, so I do not know if there is anything else wrong. I will be seeing the doctor tomorrow morning (Friday). I guess he will let me know what to do to get my creatinine back down to normal.

Please pray that my creatinine will go lower and that there will not be anything wrong with me. Thanks!

Lab Update from Monday and Thursday

Greetings blog readers! With today comes another chapter in the ever-so-interesting world of Nathan's Lab Reports (patent pending). If you remember our last conversation, I had a slightly higher creatinine than I had in the past, so the doctor had my blood drawn both Monday and Thursday to see if there was a problem.

The blood draw last Thursday, this Monday, and this Thursday all showed that my creatinine was up to 1.1. The PA that I saw this week said that I should not worry. I have gained about ten pounds since I was in the hospital to get my transplant, and higher mass can cause higher creatinine. She said not to worry about it, and that it was not a problem.

She also congratulated me again on my high number from the Glofil test. She said I should be very pleased with my new kidney and at how well it was functioning. She also said that she didn't see any other problems with my other labs.

I am going to try and list the full lab results for Monday and Thursday below. It might not fit on everyone's screen, and I apologize. Just change your resolution to 1024x768 or higher today to view the report, and then you can switch back to whatever you were using before.

Enjoy.

PROCEDURE	03/05/07	03/08/07	UNIT	REF RANGE
[Profile: CMP]
Creatinine	1.1 H	1.1 H	mg/dL	0.4 - 1.0
Blood Urea Nitrogen	11.0	12.0	mg/dL	8.0 - 20.0
Sodium	139.8	140.0	mmol/L	136.0 - 144.0
Potassium	3.5 L	3.3 L	mmol/L	3.6 - 5.1
Chloride	108.0	107.2	mmol/L	101.0 - 111.0
CO2	25.7	26.1	mmol/L	22.0 - 32.0
Glucose	115	105	mg/dL	74 - 118
Calcium	9.5	9.6	mg/dL	8.9 - 10.3
AST	-	24.0	U/L	15.0 - 41.0
ALT	-	48.0	U/L	17.0 - 63.0
Alkaline Phos	-	68.0	U/L	38.0 - 126.0
Albumin	4.4	4.6	g/dL	3.5 - 4.8
Total Protein	-	6.5	g/dL	6.1 - 7.9
Total Bilirubin	-	0.7	mg/dL	0.4 - 2.0
[Profile: GCT]
GCT	-	59.0 H	U/L	7.0 - 50.0
[Profile: MAGNESIUM]
Magnesium	-	1.7 L	mg/dL	1.8 - 2.5
[Profile: PHOSPHORUS]
Phosphorus	3.1	3.5	mg/dL	2.4 - 4.7
[Profile: CBC]
WBC	8.4	7.9	K/uL	4.0 - 11.0
RBC	4.46	4.51	M/uL	3.8 - 6.2
Hgb	15	15.1	g/dL	11.5 - 18.0
Hct	42.7	43.2	%	35.0 - 54.0
MCV	95.8	96.0	fl	80.0 - 100.0
MCH	33.7	33.5	pg	27.0 - 34.0
MCHC	35.2	34.9	g/dL	31.0 - 36.0
RDW	12.4	12.5	%	11.5 - 14.5
Platelets	223	214	K/uL	150 - 450
# Neut	5.33	4.77		1.40 - 6.50
% Neut	63.60	60.10	%	42.20 - 75.20
# Lymph	2.59	2.38		1.20 - 3.40
% Lymph	30.90	29.90	%	20.50 - 51.50
# Mono	0.32	0.53 H		0.10 - 0.50
% Mono	3.84	6.65	%	1.70 - 9.30
# Eos	0.04	0.08		0.00 – 0.70
% Eos	0.51	0.95	%	0.00 – 7.00
# Baso	0.1	0.19		-0.00 – 0.20
% Baso	1.24	2.41	%	0-0.00 – 2.50

Creatinine Still at 1.1

When I saw the doctor on Thursday, my creatinine was at 1.1. This was higher than the 0.9 or 1.0 that it had been since my transplant. So, the doctor advised that I go to the clinic on Monday (yesterday) to have my blood drawn again to make sure that I was okay.

I got a call from the clinic this morning. They told me that my creatinine was still at 1.1. This is not an "abnormal" number, it is just higher than I had been, so the doctor wants to watch it. I will go back to the clinic for another appointment on Thursday, so hopefully, the doctor will let me know what to do about this.

The creatinine is a reflection of how well your kidney is functioning. Basically, the higher the number, the worse the function. So, 0.9 is much better than 1.1. I will just have to wait until Thursday to see if I need to do something or make any changes.

I will let you know what I learn after my appointment! Enjoy your day.

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!