Double Surgery!

I know, double surgery sounds pretty bad. I probably should have title this post: "More News from the Doctor" or perhaps "What I've Learned" instead of Double Surgery. But, I did not. Now that you are tired of me explaining my choices, I guess I should talk about my surgery.

So, if you've been reading, you've noticed that I've been complaining of a chronic cough for a couple of months now. My nephrologist scheduled a CT scan for me on July 14, and they looked at my chest and sinuses. From there, I was referred to an Ear, Nose, and Throat doctor (or ENT for short - and no, not the Ents from Lord of the Rings). This doctor looked at my CT results, and looked up my nose, and said that I would need surgery to fix my problem.

I would normally have complained about surgery, except that this is what the kidney doctor had recommended as well. Since the two doctor had never spoken, I am going to guess that the opinion of two doctors is probably pretty good.

So, you've all read the post about my CT scan results by now. And, if you haven't, then go read it at: http://nmccart.blogspot.com/2008/07/many-tests-later.html

I am going to have a "Nasal Septal Reconstruction" to relieve my Deviated Nasal Septum. I am also having "Functional Endoscopic Sinus Surgery" to relieve my Chronic Sinusitis. What does this mean? The first one, the NSR (as I choose to call it) will fix my deviated septum. It's basically the seperation between the two sides of your nose. Mine is not straight, and they are going to fix it. It should help me breathe and drain better. The second surgery, or FESS (that doesn't sound as good as NSR did) is to clean the sinus polyps out of my sinus cavity (in my cheeks). I think they must have been there a while, because they are a decent size, and I have a runny nose ALL the time.

The surgeries will be on Monday, August 11, in Baylor University Medical Center in Dallas. It is outpatient surgery, so I should not be there more than a few hours. All I have to do now is to pick up my CT charts and pre-register. (The doctor wanted to look at the actual scans before doing any work).

Please pray that the surgery goes well and that I recover quickly. It should not be a long reocvery, but I am looking forward to getting rid of this cough and possibly even breathing easier all the rest of the time!

Enjoy your week everyone. I'll try to blog again after the surgery.

My First Post-Transplant Clinic Visit

Good afternoon everyone. And, if I don't see you again, good evening, good night, and good morning. We are home from Fort Worth for the weekend. I had my first post-transplant clinic appointment today, and everything is great!

We arrived at the hospital around 9:00 am for blood work. The phlebotomist had a little bit of trouble getting the needle into my vein ... so that wasn't so great. I don't see any bruising yet, so maybe it felt worse than it was. She drew four vials of blood, and then had me give a urine sample. I have to say, it has been a long time since I have had a urinalysis done. Then, I was able to take all of my medication and go eat breakfast. Luckily, our hotel had a continental breakfast, so I was not without some food.

We then headed over to the clinic waiting area to do just that -- wait. Our "appointment" was scheduled for around 10:00, but the doctors said that was merely an estimate. They have to process the blood work and get results before they can actually be helpful in seeing you. We went in around 11:30 to see the doctor. He had all of my lab results (which I can share a portion of below) and said that I was doing great. He put me back on my allergy medication, as well as my high blood pressure medication and some of the meds I got on after my stroke. He also doubled my dosage on the anti-viral medication, which he said was a normal dose.

All in all, I am doing well. My incision is healing as the doctor expected. I am healthy, and moving around, and feeling much better. The numbers on my lab reports looked pretty good, and I expect them to stay in line as I feel great.

Here are some of the important lab numbers:

• Potassium was 3.9 (range is 3.6 - 5.0)
• Creatinine is 1.0 (range is 0.7 - 1.2)
• BUN is 14 (range is 9 - 20)
• Phosphorus is 2.0 (range is 2.7 - 4.5)
  This is a little low, but the doctor said as long as it stays 2.0 or above, I will not need any supplements. He also said it was normal for post-dialysis patients to have a low phosphorus for a while, as it has become used to not processing it.
• Glucose is 87 (range is 75 - 110)
• Cholesterol is 133 (range is 0 - 200)
• Hemoglobin is up to 11.6

Keep in mind for you international readers that all these units are American. I have seen some people in other countries that want a creatinine over 100, but if I were to have that, I'd be pretty dead ... so don't worry. A creatinine of 1.0 mg/dl in the United States is the same as a creatinine of 88.4 µmol/L in SI units.

In other news, we plan to stay home for the weekend, and eat up all the food in our refrigerator before it goes bad. We haven't been home in a while, so that's always important. We are going to go back to the hotel in Fort Worth on Sunday for another fun-filled week of labs and clinic appointments.

I received a comment on a 2006 post today from a guy named Mark. Mark, if you get this far in your readings and still have questions, please send me an e-mail. The address is at the bottom of the blog.

Thursday, January 18 - Update

Welcome to my blog, following my chronicles as a Polycystic Kidney Disease sufferer and a recent kidney transplant patient. My story has several chapters, and the one I am currently on is titled: "Post Transplant: or How I Learned to Stop Worrying and Love the Kidney."

We went to Fort Worth to receive our transplant, because that is where the cadaver organ was sent. It is a little over 50 miles away from our home, so that makes for a long drive with follow-up appointments. This would not normally be a problem, except that we live in Texas. For those of you with access to the Weather Channel, you will know that ice and snow have been blowing through the area since late last week. Now, of course, that is "Dallas" snow and ice. So, for those of you up north, what it means is that it is cold and rained, and then the road froze. This scares most drivers to death, making the roads much more hazardous than they would have been if I lived somewhere that actually knew how to deal with snow and had drivers that learned to drive in it (more than once or twice a year).

I say all that to say, we decided to stay in Fort Worth for a while. We have follow-up appointments at the hospital until the staples come out of my incision (I think). This is normally about two or three weeks worth of appointments, three times a week. They draw blood at each appointment and verify that all of my anti-rejection medications are being given in the right amounts. If not, they can dynamically adjust my medications on a regular basis to give me the best chance to keep my kidney.

So, it's Thursday, and I am blogging from a hotel. The Fort Worth Stock Show is in town, so we had to find a room with no cows in it. It's not bad, but the mooing might get to be a little much at night, we will have to wait and see. We will stay the night and go to our appointment in the morning and then head back home. But, we will return next week for another full week of hotel stays and mooing (or not, I think the Rodeo finishes this weekend).

I don't know how long we will have to come down here, but it should not be a problem. The insurance company will "help out" a little with the cost, so that should be nice. And, I should get my paperwork next week (or sometime) to fill out my information for Short Term Disability. This way, I can still get a little money while I am not working. I am hoping to be released to do part time work from home eventually, so that I can start getting back in to everything.

Well, thanks for reading. I will try and post again tomorrow, but probably not until we get home. Maybe I will have some good information, lab report wise, since I know you all were starting to miss those from my old dialysis reports.

See you tomorrow!

Tuesday Morning

We just completed our post-transplant meeting. The nurse went over all of our medications with us to tell us what to take and when to take them. She talked about all of our post-transplant life changes that we will be dealing with, as well.

For starters, we should be released either today or tomorrow, depending on how quickly everything can get completed today. We begin by going to the clinic every Monday, Wednesday, and Friday for the next two weeks. We have a lab appointment where they check all of our blood levels, and then a clinic appointment where they check our medications and we meet with the doctor to make sure everything is still going well.

I have 10 medications on my list as of today. Once we see the doctor, we will have to ask about all of my old medications and see which of those I will need to continue taking and what doses or schedules I will need with those. They gave us a spreadsheet to track when we take all of our medications, and also another sheet to mark weights, temperatures, and blood pressures. I am sure I will be updating those sheets into one sheet on the computer once I get home to a printer.

For now, we are probably going to avoid going to too many public places until we are finished with our two weeks of constant clinic visits. Once that is completed, we will ask about going to church and possibly about working from home. We will also have to check about Jenny's job working with children and find out what precautions that she will need to start taking.

Also included in my folder of post-transplant goodies is a guide to writing a letter to the donor family. I will have to read through that when I get home to write a "good" letter to the family to thank them for their gift. I don't want to break any protocols, so I will make sure to follow all of the directions.

They told us not to go home until we had received a 30-day supply of all of our new medications. I know that might delay us from going home, but we will see.

I will try to make another update today if I find out more. Time for lunch!


By the way, I was asked a comment about eating yogurt. During dialysis, you cannot have a high dairy intake because dairy products are high in phosphorus, which builds up in your blood during dialysis. Now that I have a normal kidney again, I can have all of the phosphorus-laden foods that I know and love. Thanks for the comments, hbk.

Monday Afternoon Update

So, it is time for more updates. I know everyone is excited to hear about the updates, so I am trying to keep everyone up-to-date.

First of all, my creatinine is down to 1.2 (from 10.3 on Friday). Creatinine is a waste product from protein in the diet and from the muscles of the body. Creatinine is removed from the body by the kidneys; as kidney disease progresses, the level of creatinine in the blood increases. What we want is a value of less than 1 (here on the American system of measurement).

My hemoglobin is up to 9.3 from 9 yesterday. It was 14 when I came in to the hospital. This means that I am still a bit anemic, but that should get better as I continue to recover. Hopefully I will not need to take any hormone supplements to increase my hemoglobin until the kidney kicks in production of the hormone needed to prompt my body to produce red blood cells.

The nurse removed my Foley catheter this afternoon. This was wonderful. I no longer have to haul along a bag with me when I go walking around the nurse's station. And, I was able to take a nice long shower (which was nice). I am all clean and feel refreshed. This is the first "real" shower that I have had since the transplant.

The doctor said that they would add a diuretic to my pill regimen to help me get rid of some of the water weight that I have put on since the surgery and due to the steroids. That should take off some of the 20 lbs that I have added on this week. So, that will be nice, to let my socks fit again!

They are going to have a post-transplant class tomorrow morning. This will be for the four patients that had transplants on Thursday and Friday. We should learn about our at home medications and what we need to do to take care of ourselves now that we have a new organ.

Thanks for coming by to read. I will keep updating as I learn more.

7 am Monday Morning

Welcome to Monday morning, faithful blog readers. I can see (by looking at my counter statistics) that my daily readership has gone up quite a bit since Thursday night. I guess a few more people have become interested since I received my transplant!

So, there is not too much to tell this early in the day. I was having a little pain in my calf yesterday, so they did a scan to make sure there was not a blood clot. The nurse told me that it was all clear and that there were no clots in my leg. This is good. I have been walking around a lot, so I did not expect there to be any problems.

My blood pressure was 139/66 this morning. I am not sure if they are giving me any medication for that yet or not. It has been fluctuating up and down a little bit around that point since the transplant. They weighed me this morning, and I was 80.3 kg, which is the heaviest I have ever been. This is a result of the anti-rejection medications, especially the steroids, but that should get better as that dosage gets reduced.

I have a central line in my neck that was placed for emergency blood transfusions during surgery but was never used. They had it hooked up until yesterday to put in my IV fluids. They removed the IV Saturday, but left the line in to draw blood. This morning, however, the central line did not work so they had to do a stick in my arm. I am hoping that they will remove this central line from my neck, as it is not the most comfortable thing you can have installed.

I am feeling pretty good today. I am hoping that since it is Monday, we will see the post-transplant nephrologist and he can start talking to us about what to do once we go home (which should be on Tuesday). As of this point, I don't know if we will go home or if we will try to stay at a hotel in the area. We have to come to this hospital here in Fort Worth for the next two weeks (on Mon, Wed, and Fri) and I don't know if we want to drive the whole hour down here that many times. We will have to see. The insurance was supposed to have an allowance set up to allow us to stay in a hotel, but I don't remember exactly how to access it. We will have to talk to the social worker today or tomorrow and find out if she learned anything about it.

Well, hopefully, breakfast will be here soon and I will get to eat. I enjoyed having yogurt for the first time in over a year yesterday. I hope I ordered some more for today. It was really very good, and I know I have been missing my dairy products. I had cheese on my sandwich for lunch yesterday, and I had some pudding for supper. Mmm.

Well, not more posting for this morning. I will try to update again if anything else happens. If you want to call this hospital room, the number is 817-922-2817, and I should be here until probably Tuesday.

Thanks for coming by to read!

Sunday Update II

It is around 6:30 pm Sunday, so I thought I'd take an opportunity to update the blog again. My mom and her husband and here in Fort Worth. They came in Saturday evening and are leaving tomorrow in the morning. They took Jenny out to dinner, so I have an hour or so to myself. I spent about 10 or 15 minutes walking around the nurse's station, and now I've made a couple of return phone calls and am sitting down to blog.

I've been getting several phone and e-mail questions, so I thought I would answer the big one:
Nathan, will your new kidney "catch" the polycystic kidney disease?

The answer is no. Polycystic kidney disease is a genetic disease that is in my DNA. Scientists will tell you that DNA is some really long something that every person, place, thing, or idea has (or maybe that's a noun). My DNA contains the "DaVinci Code" that tells my own personal kidneys that they want to grow cysts (or fluid-filled sacks) in place of real decent kidney material. Fortunately for me, the new kidney was born inside someone else who doesn't have my genetic disease (I hope). My body will not pass the disease on to the new kidney. And, unless the donor had the disease and didn't know it, then I won't catch it from him.

It is possible that there are unknown facts surrounding the new kidney. The hospital can only give out certain information, due to privacy laws and such. But, they did tell me that the kidney came from a 17-year old male. That is great news, meaning the kidney should probably out-live me. And, I imagine that most 17 year olds are in better health than I was, so his kidney should have been in real good shape. I think they mentioned that he was in an accident, so he didn't die of a physical problem, which leads me to think the kidney will be healthy as long as I take care of it.

I am still taking my anti-rejection medications. They have been checking my blood sugar (since some of the medications can raise your blood sugar). It was fairly high right after the transplant, but it was only 101 right before supper today. They told me that anything under 100 was good, and they have not given me insulin since Saturday, so I am guessing they are not too worried.

In other news, my feet are kind of swollen, and my legs are a little swollen. They nurses and doctors said that this was normal and to be expected considering the weight gain, the extra fluid, and the medications. As the kidney kicks in more, that fluid should mostly get drained off, and I should get back down to a better weight. I don't know that I will be 71.5 kg again, but I would be happy with anything under 73 kg. That feels about right for my height and body size.

I was able to take a shower this afternoon, which was very nice. I had to cover up the central line in my neck with plastic, which wasn't that great. And, I could not scrub the kidney incision (which wasn't so bad), but I was able to rinse all of the sweat and blue antiseptic. I am feeling much much better now, physically. I am glad to be clean again.

Well, everyone is back from dinner, so I am going to sign off for now. Send in your comments and e-mails, and I will try to get back to you. Enjoy your day!

Sunday Morning Transplant Update

Welcome to the blog today. It is Sunday, January 14, 2007 at about 1:00 pm. For those of you just joining us, I received a kidney transplant (from a cadaver) on Thursday night around 11:00 pm. I was diagnosed with Polycystic Kidney Disease in 1998, and have been on hemodialysis since August of 2005. I am currently staying at Baylor All Saints Hospital in Fort Worth, TX, while I recover from my transplant.

My creatinine (which is a measure of kidney function) has gone down from 10.3 (right after the transplant) to 2.0 this morning. Normal kidney function runs less than 1.0, which means that my new kidney is functioning very well. My other lab numbers seem pretty decent. My urine output has gone from 235 ml to 2600 ml. The kidney doctor said that this was great, in fact a little more than I was taking in. The kidney is getting rid of all of the waste that my body has been building up over the last year of so. The only negative things are that my hemoglobin is only around 9, which means I am a little bit anemic, but the doctor was not worried yet. And, my weight has gone from 70.5 kg up to 79.7 kg (155 lb to 175 lb). This is due in part to some fluid retention and also due to the anti-rejection medications. They can cause weight gain, and I have not done a lot of exercise yet.

Speaking of exercise, I have been doing about 5 laps around the nurse's station after each meal. The doctors and nurses have been impressed that I am up and moving around as much I have been. That helps me to feel better and to keep up my circulation. The doctors and nurses are all glad to see me walking around.

It seems like I am rambling a little bit. That is probably due to having a bit of pain medication in my system. I haven't been taking too much, as the pain is not too bad. They removed the bandage over the staples, and there are 23 of them holding my kidney hole closed. I will blog again later when I am a little less drowsy.

Please feel free to comment, send e-mail, or to call the cell phone. Jenny or I will talk to whomever we can.

Saturday Morning

It is Saturday morning. I had my kidney transplant late Thursday night. I was in the ICU most of the day Friday, though they moved me in to a room around 6:00 pm Friday night. They want me to sit up or walk around as much as possible to speed up the healing process.

The new (pre-owned) kidney seems to be working pretty well so far. My urine output was 235 ml on the 11th and 2795 ml on the 12th. They have not posted my numbers for today. My creatinine went from 9.1 on Thursday to 10.3 Friday and the doctor just said it was around 5 today.

So, I have some pain in my right side, but that is to be expected. I hope to keep getting better through the weekend.

Stay tuned for more details.

Out of ICU

This is Jenny again. Nathan is doing really well today. His blood pressure is up and his kidney is making more and more urine each hour. He's putting out almost as much as the doctors are putting in. He was on the liquid diet for lunch and he ate everything on his tray (except the iced tea). They upgraded him tonight to the full menu. He wasn't quite ready to eat real food yet so he had pudding and some soup.

The surgeon came in this afternoon and was so pleased with Nathan's progress that he moved him out of ICU. He is now on the transplant recovery floor. If he continues to do as well as he has done today they doctor says he will probably get to go home on Tuesday.

For those of you who live in the area and want to know exactly where Nathan is...he's at Baylor All Saints in Ft. Worth (on 8th Ave off I -30). He's in Building A, 8th floor, Room 17. Now that he is out of ICU we can turn our cell phones on in the room. Feel free to call either number you get the latest information.

Thanks again for your prayers!

Transplant Surgery

This is Jenny, Nathan's wife. Nathan decided to let me post once again. They took Nathan down to surgery at about 9:45 last night. The surgeon came up to talk to us at about 3:30 this morning to tell us that things went well. He said that everything went very smoothly, all of Nathan's other organs were in exactly the right place and he was able to put in the new kidney in the perfect spot. The surgeon's only concern was that the new kidney did not immediately pink up when he connected it. He said that sometimes the kidney can be in shock and may take a few days to become fully functioning. . Once the kidney did pink up it began to make a little urine. The doctors and nurses said they will watch the urine output very closely and it should continue to improve. Nathan's blood pressure was also a little low last night ,most likely due to medications given during surgery. When I left they were just about to give him some new medication to raise the blood pressure. They doctor said that a higher blood pressure would also help the kidney to put out more urine. I called the ICU at about 8:45 this morning to check on Nathan and they said he was doing very well. His blood pressure had come up and he was asking when I was coming to visit.

Nathan will be in ICU all of today and probably most of tomorrow. Then he will be transfered to the transplant floor to continue recovery. The ICU allows 2 visitors at a time for short visits. There are no visitors allowed in ICU from 6-8am and 6-8pm because the nurses are changing shifts. Once he is transfered upstairs he can have visitors as long as he feels up to it. We would ask that if you are not healthy please do not come visit until you are well.

Please feel free to call Nathan's cell phone or my cell phone if you have questions or want other updates. We'll try to post again in the next few days.

We really appreciate all your prayers. Continue to pray for healing and that the kidney continues to make urine and his body does not reject it. Thanks for reading!

Transplant Scheduled for Today

Well, I am here at Baylor All Saints Hospital in Fort Worth. The doctor came in at 1:00 to tell me that I have a negative cross-match. The doctor said that there are two donors, and four recipients today. The surgeries started at 2:00 pm today. I am not sure when my turn is, but it will be this afternoon.

Please pray everything goes well. I will have Jenny post an update after surgery some time.

4 AM Thursday

The phone rang at 4:00 am this morning (about an hour ago) to tell me to get down to Baylor Dallas for a blood draw and then to head to Fort Worth to see if I am a match. It seems that there is a cadaveric kidney available in Fort Worth and that I am at the top of the list to get it. All they have to do is check my blood (4 hours of waiting) and see if I will have an adverse reaction.

If you see this on Thursday morning, please pray that God's will be done in seeing if I should get this kidney. If I do not get it, I will make another post today to let you know.

So, today is exciting -- we will see what it brings.

(Note: This did not post at 5am as expected)

414 Flow Rate

Last night at dialysis was the quarterly test of access flow rates. The technician told me that they do the testing on a regular basis, and since I am using the large needles now, they can go ahead and test me. If you remember, I had to get a fistula revision and a perm-cath because my flow rate was under 400 back in October. So, the test was all important for me. When it was finished, the technician told me that I was running at 414, which was great news. I also found out that the highest flow rate she had ever seen was 2000. That information suddenly changed my thinking. I had thought that maybe 500 was the top, so 350 was not so bad. But, if you can have a flow rate over 2000, then my paltry 350 was pathetic. Now that I am over 400, I hope that my fistula will continue to develop for as long as I am on dialysis.

I have to go to the hospital in about an hour to have my perm-cath removed. So, after two months, I will not have tubes hanging out of my chest! I am sure that having it removed won’t be the most pleasant thing I do all day, but I imagine that it won’t be worse than having the neck catheter inserted or removed. So, if you read this before 11am Friday, then know that I am on my way to feeling like a normal person again. If you read it after 11, then I am probably back at work sans-catheter. And, if you are reading this on Saturday morning, then I am enjoying a long, hot shower, so don’t call and bother me, lol.

There is not really too much more going on. I have one more treatment (Saturday) when I will be recording my blood pressure. I am on Diovan, Toprol XL, and Norvasc, at the moment. I will send another two weeks worth of BP data to my cardiologist on Monday, and we will see what she wants to do from there. My pressure has been down more often, but I still see it in the 150s from time to time. I don’t want it to drop too low, so the medication is a delicate balancing act.

Thanks for reading!

Perm-Cath: Placed

On Thursday, I was scheduled to have the temp-cath removed from my neck, and I was supposed to have a perm-cath placed in my chest. Let me just describe for you what went on Thursday (the story ends well, so don’t fret).

Last week, I was told that my procedure would begin at 8:00 am and that I would need to arrive at 6:00 am to be processed and prepared for the surgery. Now, as luck would have it, we had a huge cold front and almost no precipitation on Wednesday night, which caused all of the schools in the area to either close or to open late. I was told to base my decision on coming to the hospital per the local school district. So, if our town is closed, then the radiology department will not be open. I watched TV until 5:30, when we had to leave to get to the hospital. The school district was not listed, so we went. The roads had almost no ice on them at all, and driving was absolutely no problem. We listened to the radio on the way to the hospital, and they did not list the school as being closed.

We arrived at the hospital to find that the school district had been closed on our way there. But, since we had already arrived, they called radiology, and said we could go back and that they would take care of us. I got my paperwork completed and had an IV by 6:30. The doctor finally came to see us at 10:00. It seems there was some miscommunication between the nurse and the doctor, and our doctor was the only one that did not show up to work on time that day. So, there was a LOT of sitting that we had to do.

My procedure went great once we got started. They took me into radiology at about 10:30, and I think we were home by 1:30. They removed the temporary dialysis catheter from the right side of my neck. They just had to cut the stitches and pull it out, it wasn’t too painful. Then, they held the hole until it stopped bleeding so that they could patch it up. I then felt the knock-out juice going into my IV, and that was all I remembered. When I woke up, the entire right side of my chest hurt, and I now have two small tubes hanging out of the middle of the right side of my upper chest. They sent me home, and everything was great (especially since I finally got to eat).

I had dialysis Tuesday night using this new perm-cath, and it went great. The machine can not run quite as quickly as it can for a fistula, but it runs much better than with the temp-cath in my neck. The treatment went great as compared to last week. There were no problems with the machine the whole night.

About my only complaint at the moment is that the right side of my neck and chest are both hurting from the procedures yesterday. I did not sleep well last night (probably due to the pain). I am hoping that it will be better tonight. I don’t have to carry anything around at work, so I am hoping that the muscles will heal quickly and on their own. Oh, and another bonus, I can take showers again!

The doctor said that the site needs to have the bandages changed in three days and that I need to keep them on for at least 10 days. He said that the stitches could come out in six weeks and that it should be mostly healed by then. Apparently, the wound will form scar tissue around the catheter, which will help hold it in place more securely.

Thank you for all your prayers during my procedure. Right now, Jenny and I would like you to pray about my Saturday treatment time. Our church’s Christmas program is Saturday night, and I have to move my appointment in order to play in the program. Please pray that God will open up a slot for me somewhere so that we can participate in the Christmas program. Thanks!

Chest Catheter on Thursday

I finally have my procedure scheduled to have the temporary dialysis catheter removed from the right side of my neck and to have a new longer-term dialysis catheter placed in my chest. I am set to go in early Thursday morning to spend a half day sedated and to come out of the hospital with new and different tubes in my body. I know this sounds pretty exciting to you all, but I am actually pleased. The dialysis catheter in my neck is very difficult to deal with. I cannot get it wet, and it does not support a very good dialysis treatment. The machine has to run much slower than normal, and I cannot move (at all) for the entire four hours.

I also went to the hospital this morning for my “thyroid scan with uptake.” They radiologist gave me a radioactive iodine tablet, and wants to see me after four hours. I imagine that they are going to scan my thyroid to see how much iodine it has absorbed or possible used up. They told me not to consume any iodine for the next 24 hours. I also have to go back tomorrow morning to get a 24-hour reading on my thyroid. Hopefully, by my next update, I will have more information about my thyroid problems.

I have one more dialysis treatment tonight using the temporary catheter in my neck. I am not really looking forward to it, as it is a giant pain. I don’t like not being able to move, and my neck usually ends up hurting during most of the treatment due to staying perfectly still. I made it about two hours on Saturday before I was setting off the machine alarms every fifteen minutes. I guess I just can’t quite hold still for that long.

In other news, the surgery on my arm seems to be healing well. It is still a little swollen, but the bruising has gone down quite a bit. The stitches are starting to loosen up, and I am guessing that they will be gone in the next couple of weeks. The surgical scar itself seems like it is healing and staying clean, so that is good. I will be looking forward to when it does not hurt at all, as it still has some pain if I move it too much or too quickly.

Please pray for my procedure(s) on Thursday. Pray that it goes well and that there are no problems. Thanks!

Surgery Update

Okay, I have an update on my fistula surgery. I talked to the doctor at dialysis last night and he said that he recommends the fistula surgery. He said that it should help get my access flow rate over 400 and that is what I need to get the best dialysis possible.

So, on Monday afternoon, I will be going to the hospital to have some surgery on my arm. You can look at my last post and see that the surgeon is planning to open me up by the bend in my left elbow in order to connect my fistula to the “cephalic vein” (if I remember correctly). He will also have to put in a temporary chest catheter to facilitate dialysis while my fistula heals (probably for one month or so).

Dialysis went well yesterday. There were not any problems. My pulse was about 120 after the treatment, but I have just started on my new medications, so I did not expect any changes for a week or two.

Please pray for the following:

• Pray that my fistula surgery will go well on Monday
• Pray that the chest catheter will go in successfully and that there will not be any problems with it (they can be prone to problems)
  

Thanks for coming by to read. I also appreciate your prayers on Monday afternoon.

Isaiah 65:24 (New International Version)
Before they call I will answer; while they are still speaking I will hear.

A Successful First Week

I was released from the hospital Friday afternoon after four successful dialysis treatments. They have set me up at an outpatient dialysis clinic for the Tuesday, Thursday, Saturday afternoon (about 4:30) shift. The clinic is about ten minutes from my apartment and about ten or fifteen minutes away from work. Hopefully I'll be able to go back to work soon. Being home all summer is not as great as you might think (especially when you spend all of that time in the hospital).

I had four dialysis treatments in the hospital. They started with a short, two-hour treatment on Tuesday and worked up to a 3 1/2 hour treatment on Friday. My fistula is still new, so they are using 17-gauge needles (which I am told is the smaller of the two sizes). The are also filtering my blood at a rate of about 300 cc/min, and the normal rate is at least 400 cc/min. Since I still have one kidney that sort-of functions, the doctors are not too worried about running me at a slower rate for a couple of weeks until my fistula has gotten large enough to support larger needles and a faster flow.

I am receiving what is known as HEMODIALYSIS. This means that my blood is being filtered outside my body, much in the same way that the kidneys filter your blood inside your body. The blood comes out of my fistula and goes into the dialysis machine. The blood flows through a semi-permeable membrane (like the kidney) which helps clean impurities out of the blood. The chemical balance that your body requires is fixed, and excess fluid is removed from the body. Since my kidneys would normally remove excess fluid and any waste for me, and my kidney no longer does this successfully, I will have to have dialysis three times a week for four hours at a time until I receive a kidney transplant.

The good news is that I am finally starting to feel better. It seems like I have been sick all summer, and for the first time in a couple of months, I can go all day without feeling like I need to vomit. I am hoping that I will continue to feel better as the dialysis helps lower the overall toxin levels in my body and brings me back down to a more normal level. I'll have to let you know how dialysis goes on Tuesday.

Released from the Hospital!

Well, as the heading proclaims, I've been released from the hospital. I am barely passing any blood from my kidney now, and they have gotten my hemoglobin count back above 9 (which is pretty low, but not too terrible). The hospital has given me some antibiotics to take for the next week just to make sure that there aren't any problems with my remaining kidney. They have also given me some anti-nausea medicine. My creatinine level is back above 6 again, and I am feeling nauseated on a regular basis.

Now that I am going home, I hope that I can go back to feeling better. I don't think we are going to try and push the exercise as much as we did before I got readmitted. I don't know if that made me feel worse, but I'd rather not take chances. I'll just have to get back up to taking walks every day.

I am supposed to get some more blood work done on Thursday, and I'll see my nephrologist on July 25 when he returns from vacation. I am also going to try and schedule a Glofil test for sometime next week. The Glofil test is a VERY accurate test of your kidney function. I took a Glofil test about two years ago and had a GFR (filtration rate) of 24 cc/min. The UNOS (United Network of Organ Sharing) will not allow anyone to be considered for a kidney transplant unless their GFR is below 20 cc/min. I imagine now that I only have one kidney that I will be able to meet this limitation.

In other news, my company is changing insurance companies on August 1. I had thought that this would be VERY bad news, but it turns out not to be too terrible. We looked through the network of doctors, and found that all of my doctors are available (which is great). Also, the prescription drug program is very comparable, as we will only be spending an extra $5 every three months per prescription. The only real negative is that my yearly out-of-pocket maximum gets reset, so the money that I've paid so far this year in medical expenses will not count after August.

One final thing: As of July 10, 2005, Jenny and I have been married for one year!! Now, I know that we were celebrating in the hospital, but it could have been worse. And, the way I see it, our second year of marriage cannot be too much more stressful than our first year. Marriage is great, and I really do love Jenny a lot!

Back in the Hospital

Well, it seems that my recovery wasn't going as well as I had hoped. I had some severe nausea today, and with it a LOT of pain in my right kidney. We went to the emergency room on July 5, and they decided to admit me to the hospital for a while to watch me. I have been passing blood from my kidney for about a week now, so I think they want to make sure that gets under control as well.

It seems that all that blood I've been losing has made me severely anemic. I am scheduled for a couple blood transfusions this week (while I'm sitting here in the hospital). They are just glad that my other kidney is showing no signs of infection, so they are not afriad they will have to remove it. The doctor did say, however, that if they need to take the kidney that they will do it to keep me alive.

The transfusions help with the anemia, and the doctors have told me to stop taking my blood thinner as it is causing more harm than good at this point. Since they never determined if a clot was responsible for my stroke earlier this year, it will be better to not risk the bleeding that I am having as a result of the blood thinner. They are also giving me an artificial hormone to help my body produce more red blood cells. This hormone is normally produced by the kidneys, but my body has not made enough of it for over a year. I've been taking an artificial hormone, off and on, for quite a while now and it seems to help.

Well, hopefully I won't be in the hospital too much longer. I want to get well so that I can go back to having a normal life. Please continue to keep Jenny and me in your prayers. Thanks!