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).

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.

Bone Density Scan - Results

Here are the results from my Bone Density Scan (taken back on August 6).


This was the worse of the two results (taken from my hip bone). Though I do not know exactly what this means, there is a small chart that gives me a usable amount of information.


The small circle in that chart shows that I am at "Increased Fracture Risk." The WHO (in 1994) classified this as Osteopenia.

So, I think these are pretty similar to the results that I got back in January. If there is greater demand for more information, then I can try to find out more from the doctor when I see him next week.

So, that's it for today. Please pray that my bones don't get worse in the next six months. I am going to get back to doing regular exercise to try and keep my bones in good shape. Thanks!

Question Received Via E-Mail

I got an e-mail on Saturday asking me a question. I will reproduce the e-mail here (minus any personal information) and attempt to provide the best answer that I can.

EMAIL FROM: M.R.
DATE: AUGUST 4, 2007 at 5:42PM

Hi Nathan...

I'm writing in search of some better answers than what we are getting. My good friend is 34, male, and has PKD ( he was diagnosed about 3 years ago). We have yet to find any good help. His urine has been bloody for a week, after not being able to get into a doctor he went to the emergency room at a local hospital. After some testing and a CAT scan they said he has kidney stones and sent him on his way. Still unable to get into a specialist and still bleeding... I'm trying to be supportive and came across your site in my online searching for answers. Any advice or directions you could point me in for more answers/research would be much appreciated. I'm sure you are a busy man, but I thought I'd reach out. Your blog is great I thank you for sharing your experience!

Thank you for you time
----------

Well, I can tell you right off that I have had several kidney stones in my life. The first one was back around 1998 or so, while I was in college. Several of my kidney stones came with blood in my urine, which is never a good thing to see. If the hospital sent him home after seeing kidney stones on a CT scan, then it probably means that the stones are small enough to pass on their own. Now, having said that, the "passing" is not that easy. My first suggestion would be to see if he could get a doctor to prescribe him some pain medication that is a bit stronger than the over-the-counter stuff. I've had kidney stones that lasted anywhere from a day to a week, but usually on the shorter end, once I started feeling the severe pain. I would notice the blood in the urine for several days before having any pain (if it was a kidney stone). If you find that your friend has not passed the stone within a day or two, he should head back to the hospital to complain again, letting them know how long the pain has been going on. If he is not in terrible pain, then the only thing to do is to wait.

As long as his kidney function is still strong, the only other thing to do is to drink a lot of water. That is the only way the kidney stone will get passed. He has to keep drinking water to move the stone out of his system. In fact, I noticed that I usually would have a kidney stone about once a year or 18 months, when I had slowed down on drinking water. It is highly important to stay well hydrated. It is my understanding that keeping well hydrated will help prevent the stones from forming, or will help keep them small enough so that they do not hurt (as badly) when being passed.

And, of course, with Polycystic Kidney Disease, blood in the urine will be a common problem. Does your friend have a regular nephrologist? Is he going to see the nephrologist on a regular basis? That is the only other advice I have. Stay current with his kidney doctor so that they can track the progress of the disease and keep him ready for any problems that may come his way.

-----

I hope my e-mail was helpful. I just sent that exact text to M.R. earlier today. I hope everyone is having a good week. I had my bone density scan on Monday, and I am still in "Increased Fracture Risk" like I was six months ago. I'll know more when I see the doctor in a couple of weeks. If I get a chance, I'll try to post the results of the test between tomorrow and the next doctor's visit.

Have a great day!

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!

July 11, 2007

It has been over a week (almost two now) since my last blog update. I received several excited e-mails after my last post. Everyone was so happy to hear that I had nothing to update! So, that's always good news, though I don't know how exciting it is to read.

Let's see ... what can I say for this week's post? Yesterday (Tuesday the 10th) was my third wedding anniversary. Jenny and I have been through a lot over the past three years. We were glad to be able to celebrate at home (and not in the hospital) this year. We didn't have to go to dialysis or the hospital, so it was a wonderful anniversary!

I got my Glofil procedure scheduled for July 17, which is the same day as my next clinic appointment. If I am right on my timing, I think they will want to do my second bone density scan on the 17th as well. My first scan showed that I was a little light on my bone density. Hopefully, my density will not have decreased in the past six months.

The only other thing I can think of that is possible is that the doctor may take me off of the Bactrim. I've been on it for six months, and I think that the original nephrologist said that I would only be on the Bactrim for six months. If not, then I'll have to get a new prescription for it, since I have no more refills. I'm thinking it's the end of taking that one.

That's about it for today. I'm feeling healthy and drinking lots of water. I'm trying to do some exercise (either walking or riding my bike) several days a week after work, though it's not as easy as it was when I wasn't working.

See you next time!