Friday Update and Full Lab 2007-01-26

Time for a quick Friday update. I slept a little bit better last night than I did the night before. I think that the exercise probably did help a little bit. I decided to walk 30 minutes today, for a total of about 1.01 miles. Maybe walking a bit longer will help me to feel better and to sleep better.

I went by the dialysis clinic last night to see one of my dialysis friends. He was the guy that sat beside me for about a year. He said that he also received a call from the hospital offering him a kidney the night I was called. He refused it, because it was not a good match for him. He is an older gentleman, and is much more picky about which kidney he takes, since he figures that it will be the only one he ever gets (at his age).

So, that's about it for today. I would still like prayers for my recovery and for sleep. Thanks for coming by. All that is left in today's blog is the lab report from Monday, the 26th. Enjoy.

Here is the full lab report from 2007-01-26 (last Monday). I shrunk down the table a little bit, hoping to get a little more of it to fit on those 800x600 screens that some of you are using.

PROCEDURE	RESULT	UNIT	REF RANGE
[COMP METABOLIC]
SODIUM	140	MEQ/L	(136 – 145)
POTASSIUM	3.9	MEQ/L	(3.6 – 5.0)
CHLORIDE	103	MEQ/L	(98 – 107)
CO2	28	MMOL/L	(22 – 30)
ANION GAP	9	MEQ/L	(6 – 16)
GLUCOSE RANDOM	82	MG/DL	(75 – 110)
CREATININE	1.0	MG/DL	(0.7 – 1.2)
BUN	14	MG/DL	(9 – 20)
BUN CREAT RATIO	14		(7 – 25)
CALCIUM	9.6	MG/DL	(8.4 – 10.2)
TOTAL PROTEIN	7.3	G/DL	(6.4 – 8.3)
ALBUMIN	4.7	G/DL	(3.5 – 5.0)
GLOBULIN	2.6	G/DL	(2.4 – 3.5)
A/G RATIO	1.8		(1.1 – 2.2)
BILIRUBIN TOT	0.4	MG/DL	(0.2 – 1.3)
ALK PHOS	84	U/L	(40 – 129)
AST	20	U/L	(10 – 50)
ALT	66H	U/L	(10 – 50)
[MAGNESIUM]
MAGNESIUM	1.5L	MG/DL	(1.7 – 2.6)
[CBC]
WBC	9.3	K/UL	(4.5 – 11.0)
RBC COUNT	3.80L	M/UL	(4.5 – 6.00)
HEMOGLOBIN	12.7L	G/DL	(13.5 – 18.0)
HEMATOCRIT	37.9L	%	(40.0 – 52.0)
MCV	99.7H	FL	(80.0 – 99.0)
MCH	33.4H	PG	(27.0 – 33.0)
MCHC	33.5	%	(32.0 – 36.5)
PLATELET COUNT	223	K/UL	(140 – 440)
RDW SD	54.2H	FL	(37.0 – 51.0)
RDW DV	14.8H	%	(10.0 – 14.5)
MPV	9.9	FL	(8.5 – 12.0)
SEGS	64	%	(45 – 75)
LYMPHOCYTE	30	%	(20 – 45)
MONOCYTE	6	%	(2 – 9)
EOSINOPHIL	0	%	(0 – 5)
BASOPHIL	0	%	(0 – 2)
SEGS ABS	5.95	K/UL	(2.03 – 8.25)
LYMPHOCYTE ABS	2.79	K/UL	(0.90 – 4.95)
MONOCYTE ABS	0.56	K/UL	(0.09 – 0.99)
EOSINOPHIL ABS	0.00	K/UL	(0.00 – 0.55)
BASOPHIL ABS	0.00	K/UL	(0.00 – 0.22)
ABS NEUTROPHIL	5.95	K/UL	(2.07 – 8.80)
MANUAL BAND	0L	%	(1 – 4)
MAN METAMYELOCY	0	%	(0 – 1)
[PHOSPHORUS]
PHOSPHORUS	3.4	MG/DL	(2.7 – 4.5)
[RT UA]
URINE COLOR	YELLOW
URINE CHARACTER	CLEAR		(CLEAR)
SPECIFIC GRAVITY	> 1.030
URINE PH	5.0
URINE PROTEIN	POS 1+		(NEGATIVE)
URINE GLUCOSE	NEGATIVE		(NEGATIVE)
URINE KETONES	NEGATIVE		(NEGATIVE)
URINE BILIRUBIN	NEGATIVE		(NEGATIVE)
UR OCCULT BLOOD	POS 2+		(NEGATIVE)
URINE NITRITE	NEGATIVE		(NEGATIVE)
UR UROBILINOGEN	0.2	EU/DL	(0.2 – 1.0)
LEUKOCYTE ESTER	TRACE		(NEGATIVE)
URINE WBCS	30 – 50		(0 – 1)
URINE RBCS	15 – 30		(0 – 1)
EPITHELIAL CELL	FEW
BACTERIA	MOD		(ABSENT)
URINE CRYSTALS	PRESENT

Thanks for reading!

Thursday Update Plus Full Lab Report for 2007-01-24

It is Thursday morning, and I would like to report that I had a much better night's sleep last night. I do not know if it was the extra exercise, or the prayers, or what exactly helped me, but I was able to get a good night's sleep. I went to sleep around 10:00 and got up around 7:00, so that was good. I am glad that something (at least) is helping. Maybe I will not need to change medications after all. We shall see.

Thank you all for the prayers. I was able to sleep, and I am feeling well today. I guess it will be more exercise and more TV watching today (as Jenny and I clean off our DVR). Thank you all for your prayers, and please continue to keep me in your prayers this week. Our next clinic appointment is on Monday.

Here are the full lab reports from Wednesday the 24th:

PROCEDURE	RESULT	UNIT	REF RANGE
[BASIC METABOLIC]
SODIUM	140	MEQ/L	(136 – 145)
POTASSIUM	4.3	MEQ/L	(3.6 – 5.0)
CHLORIDE	104	MEQ/L	(98 – 107)
CO2	28	MMOL/L	(22 – 30)
ANION GAP	8	MEQ/L	(6 – 16)
GLUCOSE RANDOM	83	MG/DL	(75 – 110)
CREATININE	1.0	MG/DL	(0.7 – 1.2)
BUN	9	MG/DL	(9 – 20)
BUN CREAT RATIO	9		(7 – 25)
CALCIUM	9.6	MG/DL	(8.4 – 10.2)
[MAGNESIUM]
MAGNESIUM	1.4L	MG/DL	(1.7 – 2.6)
[CBC]
WBC	8.3	K/UL	(4.5 – 11.0)
RBC COUNT	3.45L	M/UL	(4.5 – 6.00)
HEMOGLOBIN	11.7L	G/DL	(13.5 – 18.0)
HEMATOCRIT	34.3L	%	(40.0 – 52.0)
MCV	99.4H	FL	(80.0 – 99.0)
MCH	33.9H	PG	(27.0 – 33.0)
MCHC	34.1	%	(32.0 – 36.5)
PLATELET COUNT	234	K/UL	(140 – 440)
RDW SD	54.5H	FL	(37.0 – 51.0)
RDW DV	15.0H	%	(10.0 – 14.5)
MPV	9.7	FL	(8.5 – 12.0)
SEGS	59	%	(45 – 75)
LYMPHOCYTE	33	%	(20 – 45)
MONOCYTE	7	%	(2 – 9)
EOSINOPHIL	1	%	(0 – 5)
BASOPHIL	0	%	(0 – 2)
SEGS ABS	4.90	K/UL	(2.03 – 8.25)
LYMPHOCYTE ABS	2.74	K/UL	(0.90 – 4.95)
MONOCYTE ABS	0.58	K/UL	(0.09 – 0.99)
EOSINOPHIL ABS	0.08	K/UL	(0.00 – 0.55)
BASOPHIL ABS	0.00	K/UL	(0.00 – 0.22)
ABS NEUTROPHIL	4.90	K/UL	(2.07 – 8.80)
MANUAL BAND	0L	%	(1 – 4)
MAN METAMYELOCY	0	%	(0 – 1)
[PHOSPHORUS]
PHOSPHORUS	2.5L	MG/DL	(2.7 – 4.5)
[RT UA]
URINE COLOR	YELLOW
URINE CHARACTER	SL CLOUD		(CLEAR)
SPECIFIC GRAVITY	1.025
URINE PH	6.0
URINE PROTEIN	NEGATIVE		(NEGATIVE)
URINE GLUCOSE	NEGATIVE		(NEGATIVE)
URINE KETONES	NEGATIVE		(NEGATIVE)
URINE BILIRUBIN	NEGATIVE		(NEGATIVE)
UR OCCULT BLOOD	POS 1+		(NEGATIVE)
URINE NITRITE	NEGATIVE		(NEGATIVE)
UR UROBILINOGEN	0.2	EU/DL	(0.2 – 1.0)
LEUKOCYTE ESTER	TRACE		(NEGATIVE)
URINE WBCS	10 – 15		(0 – 1)
URINE RBCS	3 – 5		(0 – 1)
EPITHELIAL CELL	RARE
MUCOUS	PRESENT		(ABSENT)
BACTERIA	LIGHT		(ABSENT)
URINE CRYSTALS	PRESENT

Have a great day!

Restoril vs Lunesta in the Quest for Sleep

Good morning everyone. It is 4:00am on Wednesday, January 31, 2007.

4:00 am!?? What are you doing up at such a crazy time? I thought you told us that you were taking sleeping pills to help you fall asleep and stay asleep? Weren't you just telling us that the other day?

Oh, thank you for asking. For those of you wondering why I am not sleeping, allow me to explain. I am currently taking 20mg a day of a steroid called Prednisone. Prednisone is an immunosuppressant. It is also a synthetic corticosteroid drug. That means that it gives your body the signal to "wake up" after a good night's sleep. Unfortunately for me, it gives that signal all day long, including when I want to be sleeping. So, like many transplant patients, I needed something to help me sleep.

So, I am taking a medication that is supposed to help me sleep. When the doctors discharged me from the hospital, they gave me a 30-day supply of a medication called Temazepam (15mg). Temazepam is the generic version of Restoril, for those of you interested in medications. The medication warnings that I received with this medication said that it was not intended for use longer than 7 to 10 days. I took the Temazepam once we got home from the hospital, for about seven days, but I did not want to take much more of it. It did help me to sleep, and I was thankful for that. But, being a reasonable person, I asked the doctor what different medication I could take over the longer term.

At the clinic on Monday, the doctor gave me a prescription for Lunesta. That's the one you see all the commercials on TV for with the butterfly that helps you sleep. Lunesta is designed for long-term use with less chance of addiction. So, I started taking these 2mg capsules Monday evening. I slept fairly well Monday night, waking up only to go to the bathroom (which is still normal, given the new kidney and all). I went to sleep between 10:30pm and 11:00pm, and awoke a little before 7:30am. This is what I would classify as a good night's sleep.

Having enjoyed a good night of sleep on Monday, I took the Lunesta again on Tuesday night. I took it at 9:00pm with all of my other medications, just like on Monday night. We went to sleep around 10:00pm, which is about normal (for now). Again, I fell asleep fairly easily, and did not awaken until about 2:15am to go to the bathroom. Unfortunately, that was it. I laid back down, ready to fall asleep again. That didn't happen. By about 3:30, I gave up. I came out to the laptop to read my e-mail and to blog.

I find that blogging is a bit of a therapeutic kind of getting things off of my mind. I am hoping that tonight was a fluke, and that the Lunesta will work better for me Wednesday night. Maybe I did not do enough walking on Tuesday. We ran several errands, but I don't know if I got enough exercise. I will need to be better about that today and make sure that I get over to the fitness center to spend some time on the treadmill.

I don't know if I will stay on the Lunesta. It is $21.70 cheaper (every three months) than is the Restoril. And, it does not have the addictive side effects. However, if it does not provide me with any sleep, then it is still $118.86 too expensive (for a 90-day supply). I guess if I keep taking it all week, and it does not help, I will ask the doctor for something new. Ambien is only $95.49 for a 90-day supply, so maybe I will use it. Who knows?

Prayer Requests:

• Pray that the Lunesta will work for me so that I can get a good night's sleep again. Or, if Lunesta is not right for me, pray that the doctor will be able to choose something that will work for me (with my other medications and my aversion to addiction).
• Pray that I will continue to heal. The staples are scheduled to come out on Monday, and I don't want there to be any problems between now and then.
• Pray that my paperwork will move quickly at work so that I can be fully approved to work part-time from home while recovering and making weekly clinic visits. I want to get back to work not only because I have a need to be productive, but also because I am a useful member of the group and want to contribute.
• Continue to pray for the donor's family. It has been about three weeks since their loss, and they are probably still dealing heavily with the grief process.

Thanks for listening to my early-morning rant. Hopefully there will not be any more of these!!

Monday Clinic Report

Good Monday everyone. Today was my second post-transplant clinic appointment. They drew blood in the morning (they found a vein on the second stick). They only needed three vials today instead of four. They also did a urinalysis. I am still not used to those, after going so long without having to do that.

The doctor looked me over and said that everything was looking good. Here are some of the lab numbers:

• Potassium was 4.0 (range is 3.6 - 5.0)
• Creatinine is 1.0 (range is 0.7 - 1.2)
• BUN is 14 (range is 9 - 20)
• Glucose is 80 (range is 75 - 110)
• Hemoglobin is 10.8 (range is 13.5 - 18.0)
  The hemoglobin is a little low, still, but that is normal for a new kidney.

The doctor looked at my incision. There is a little bit of pinkness around it, and it is still a little swollen, but he said not to worry. There was one staple that he said might be a concern, but no problems today. He was so encouraged that he offered to let us skip our Friday appointment.

I told him that we would go ahead and come, since we have already gotten the hotel room for the entire week. Besides, I have to go on Thursday to have a bone density scan done (while I am here). So, we will have clinic again Wednesday and Friday of this week. But, it sounds like he might reduce the number of appointments that we have next week.

We will continue to have clinic in Fort Worth until the staples are taken out. After that, they will transfer us to Dallas Transplant Institute (DTI) in downtown Dallas. That will cut our drive in half, so we will not be needing to get a hotel (and we get to stay home).

The doctor said that the prednisone was the most likely cause of my sleeplessness. He said that your body produces a hormone (called cortisone) when it is time to wake up, and that prednisone is basically an artificial cortisone. So, it makes you want to stay awake all the time. He said that the sleeping pills should not be a problem and that if I need them for more than a few weeks, he would prescribe a longer-term (less addictive) sleeping pill. He also said to get more exercise (which was already a goal anyway). That should help out with sleeplessness later, too.

I received a comment asking about my immunosuppressant drug levels. My Prograf® levels at my Monday lab were 11.6. They did not make any changes to my dosage (4mg twice a day). It takes longer to get a result on your Prograf® levels than it does for the rest of the blood. If they ever need to change, then they said they will call between 2pm and 4pm. I should know this afternoon if I need to make any changes.

The doctor did make one medication change. I was taking 1000mg of Cellcept® twice a day. I was also having a lot of stomach irritation after eating. The doctor said that the Cellcept® was the most likely cause. Cellcept® is one of the immunosuppressant medications that I am on. He said it might help if I change to taking 500mg three times a day (for a total of 1500mg instead of 2000mg). I am going to start that tomorrow. I'll have to wait and see if it helps.

Well, I think that is all of the updates I have for today. Thank you for coming by. Please continue to pray that my body will not reject the kidney. Also please pray for the donor's family, as they are still grieving a loss. Thanks for reading!

Clinic Week II

We have clinic appointments on Monday, Wednesday, and Friday in Fort Worth this week. We have decided to come to Fort Worth and stay in a hotel this week. We checked in this afternoon, and our room has a microwave and refrigerator, so we can keep water cold and make some popcorn.

I am looking forward to my second lab appointment, so that I can start collecting lab reports to compare and see how I am faring. The numbers were all just on a chart in the hospital, so I did not really get to take those home.

I updated the forms that the hospital gave me. I had a 2-page form of medication reminders. I had a single page for health record information. I got on the computer, and created a one-page document that has my medication list/reminders and has the blood pressure/weight/temperature/etc for the health record. That way, the doctors and I can look in one place and see all the information. I am not a big fan of flipping through several pages just to find some information.

So, nothing new today. I am still feeling well (though a little short on sleep). I think I am going to take some sleeping pills this week and see if that helps. I also plan to ask the doctor about that tomorrow. But, I am feeling healthy, and there have not been any problems. I have not needed any pain medication in several days, and about the only pain left is just around the incision. There is still some swelling (fluid retention) around my waist and in my face and legs. But, all that should go away in time.

Tomorrow, I hope to have much more information. Enjoy!

Fistula Revision is Healing

I saw my vascular surgeon yesterday afternoon. I went in for a follow-up appointment to the fistula revision that I had done at the end of November. He ran the sonogram wand over my arm for about 15 minutes, and he said that the revision is healing very nicely. He also said that I would be ready to use it again in about three weeks.

So, that is some exciting news. In about three weeks, I will go back to the painful needles in my arm, rather than just tubes hooked up to my chest catheter. I know, it doesn’t sound all that great, but if the fistula is working correctly, then I should start getting an even better dialysis treatment. I also will get to have my chest catheter taken out a week or so after they start using the fistula again, so that will be nice. I am growing tired of covering the bandage in plastic every morning so that I can take a shower. Also, I am going to enjoy not having tubes in my chest that keep me from sleeping on my stomach. I’ll just tell you that it is not all that great to have a large bandage on your chest. My chest is small and the catheter is right in the middle of the right side of my chest. This means that the bandage has to try and curve around under my arm and attempt to stick. I usually have to tape it up (again) every morning so that the catheter stays covered up (and clean). It will not be a problem for me to stop tending to an open wound on my chest.

Our company is celebrating New Year’s Day on January 2, so I do not have to come to work that day. My mother and sister are coming to town for a short visit, so that will be fun. My mom came down at Thanksgiving and she got to see me at the dialysis clinic. I think that helped her get a better idea of what I am doing for 12 hours every week. I don’t know when they will get here, but if it is early enough, then my sister can come see the clinic as well. She also has Polycystic Kidney Disease, so dialysis and a transplant may one day be in her future as well.

So, since I am going to have some family in town, I don’t know how soon the next post will be. Stay tuned to your RSS readers, and I will update when I get a chance.

Thanks for reading today!!