ENT Visit (Forever-Cough)

OK. Here's the story so far. I had some allergy-related coughing and sneezing back at the end of March. At my nephrologist appointment, the doctor prescribed me a Z-Pak (this was early April). I took that for five days, but it did not really help. Then, I called them a few weeks later, and they prescribed me some Avelox (for ten days). That helped, some, but I still did not stop coughing. So, I called the kidney doctor a third time, and they advised that I go and visit my ENT.

I saw the ENT on Wednesday morning. He took a look down my throat, and he saw that I have a growth on my vocal folds (also called vocal cords). He said that it is probably benign, but that it is causing my vocal cords to not be able to fully come together, which allows air to aspirate and can be a big problem with my cough and allergies. He wants me to come back in the middle of June for surgery to have the growth removed.

This Friday (tomorrow), I will have a CT done on my head to check my sinus cavities. The doctor thinks that I probably have a lot of blockage up there, again. If I do, he wants to go and flush them out, again, like we did back in 2008.

So, I am going to have a head CT on Friday, and then I will check with the doctor next week to find out what they see. I'll let you guys know what I find out later. I'm guessing that I will have to have my sinus cavity washed out again.

So, the doctor said it is probably a benign growth. I have a head CT on Friday. I will have surgery in the middle of June.

Enjoy your weeks!

Nephrologist Update: April 7, 2011

OK - so I'm back again, this weekend, trying to catch up on my blog posting. As you can see, I'm still posting one month in arrears. (I admit, I phrased that last sentence just to use the word "arrears").

I went to see my nephrologist back on April 7 for my normal quarterly appointment. They confirmed that my work-up from January all looked fine. For those who do not remember, I had my annual Glofil appointment back in January. The doctor was concerned that the test results were much lower than they should have been. They had me turn in a 24-hour urine collection just to double-check the results. As it turns out, I am in the upper 70's (I don't recall the exact number). This is a little lower than the 80.2 that I got last year. They did not seem concerned about the lower number. Being in the 70's is probably still pretty good for a post-transplant patient. And, we will see how well I do next January.

Unfortunately, the clinic was having their computer system updated the week that I was there. That means, they were not able to get me my blood work results for that session. I have been feeling pretty good, so I am not concerned about not having results.

My only negative this appointment was a persistent cough. I started coughing about a week before my appointment. The doctor gave me a Z-Pack. I took it for five days, but it didn't seem to do much for me.

If we fast-forward to the present, I am still coughing (May 8). I called the doctor again this week, and I got a 10-day prescription for Avelox. I am also scheduled to see an ENT on May 18. I'm hooping that he will have some kind of suggestion to help. That, or maybe the Avelox will be working by then and I won't need anything. We shall see!

That's all for this week. If I do my job right, then I should post again after the May 18 appointment. That will get me completely up to date. And, I should be better by then (if everything works right).

See you later!

July 8: Post-Transplant Appointment

I last posted to my blog back in July. It is now almost the end of September. The easiest thing to draw from this is that I am a busy person and do not place a top priority on my blog. The thing you may not think, immediately, is that being healthy does not make for as good of posts (in my opinion).

But, as I was at the doctor the last time I posted, I figured I might as well post about that particular appointment today (while I have a few minutes). My last visit to the nephrologist, for my post-transplant follow-up, was a great visit. My creatinine is at 1.0, which is good to see. My other numbers are all still good as well. I am always glad to see good lab reports as a part of my quarterly visits.

If I remember correctly, I was a bit sick the last time I visited the doctor. I had some sort of sinus infection, which led me to have a chest x-ray. The doctor did not see any signs of problems in my lungs, which was good. I got some antibiotics from my family doctor, and they seemed to clear up the infection fairly well.

The biggest problem with being sick, as a post-transplant patient, is that it takes a long time to get better. Even with medication, I was still coughing for weeks. It means that I have to be more careful when I get sick and make sure I talk to the doctors quickly.

In other news, since my Medicare ran out at the beginning of the year, I have been paying full price for my post-transplant medications. For prednisone, this is not really a big deal. For the Myfortic and Prograf, it is quite expensive. I contacted the two pharmaceutical companies that make those medications, knowing that they offer financial assistance. I received forms from both companies, and sent in the receipts for my medications. I got back a payment of $80 for three months of Prograf. I have not seen anything from Myfortic.

So, I think that posting on Sunday morning works well. I have finished my Bible study for the morning, but am still waiting on Hannah to wake up. If I remember, I'll even update again next week about my 3-month cardiology appointment (and answer some reader questions).

Stay tuned!

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!!

Follow-Up from Friday's Appointment

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

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

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

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

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

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

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

(251) Nathan Gets Tested for CMV

Hello everyone! I'm writing today to let everyone in on what has been going on with me for the past week, and what they think is happening.

The title is sort-of a spoiler. The week has ended with me being tested for CMV. You can read all about this on the Internet, if you like. It sounds like it is a standard virus that more than 50% of adults contract in their life time. It's really not harmful, unless you have a suppressed immune system (like I do). They did the test today, and I should find out an answer on Friday.

Okay, now to rewind. I woke up late last Wednesday night (early Thursday morning) feeling nauseated. My stomach was sour and I kept having diarrhea through the night. I did not go to work on Thursday, and had a couple of vomiting spells. I cut back, and only took my transplant medications on Friday, and did not vomit any. I stayed home from work that day, too. I felt bad on Saturday and was slightly better on Sunday. I went to church Sunday and it was not terrible. I needed to rest during the day, which was good. I went in to work on Monday, but did not feel great. The diarrhea was gone on Sunday but back on Monday.

Tuesday morning (yesterday) I was sick again. I was throwing up and the diarrhea was back in full force. I stayed home Tuesday (and today). I went to the transplant doctor's office Wednesday (today) to see if they had any suggestions. They told me that I was dehydrated and had lost ten pounds. Those two items helped contribute me to having a creatinine of 1.7 (which is bad).

The doctor gave me one liter of saline and sent me to have a CMV test done at the nearby hospital. I guess they don't have the equipment to do that at the transplant office. And, it was a good way to cost me $2 for parking. I go back to the office on Friday to get my results from the CMV test (and see if they found anything).

So, in summary, I've been sick for seven days now. It's not fun, and I'm not enjoying it. I don't know what to do to get better, and the doctors don't have much information to give me, yet. I'd appreciate any prayers.

I'll give more updates when I learn more (probably after Friday's appointment).

Thanks!

(246) Monday Misadventures and a Pending Cystoscopy

So, I probably should have tried and blog about this yesterday, but I didn't take the time to do it. I wanted to let everyone know, for starters, that I am still okay and as of yet, nothing has been deemed wrong with me.

Sunday morning, I noticed some blood in my urine and some particulate as well. The particulate was small pieces that seemed fleshy. This was a bit disconcerting, but there was no pain associated with it. I had a lot of water to drink that morning (since church was starting at 10:50 instead of 9:15 that day). Going to the bathroom two more times, I still saw particulate, but the color was less red each time.

When we got home from church, I went to the bathroom again, and saw that the color seemed normal and that there was no particulate. I called the 24-hour doctor's line at the nephrologist's office, and they paged the on call physician. We talked and he said that if there was no pain that I could just go in to the clinic on Monday to be checked.

Monday, I saw the doctors. They ran blood work and everything was normal. My creatinine was at 1.0 (good) and the other results were normal as well. They also ran a sonogram on both of my kidneys (the native and the transplanted). The sonogram showed nothing abnormal on either kidney. The doctors suggested that I should have a cystoscopy done by my urologist.

I called the urologist and set up an appointment for Friday. I'm not sure if he will do the procedure in his office that day or if he will evaluate me and then set up a date for the cystoscopy. My understanding is that it can be performed in the office, depending on the "type" of test they do. The point of the cystoscopy will be to see if there is a kidney stone in my bladder. Those interested can read more here: http://en.wikipedia.org/wiki/Cystoscopy.

Please pray that the test, if needed, goes well and that this was only a burst cyst in my native kidney (or something else that was non-problematic). I'm not worried, but I would prefer if there was nothing wrong (especially with the transplanted kidney).

Thanks for reading and praying! See you next time.

Many Tests Later ...

Welcome back everyone! I know that it has been more than a month since I last posted, and many of you are wondering about how I am doing with my cough. Well, I still have it. It's been about six weeks now, and I've taken two different antibiotics as well as a cough suppressant and something to get the mucus out of my chest. None of the medications have done anything to help.

I visited the doctor last Thursday, and they told me to go and have a CT scan done of my sinus cavity and of my chest. Here are the results:

STUDY: CT CHEST/THORAX W/CONTRAST
Findings:
The heart and great vessels opacify with contrast normally. An aberrant origin of the left vertebral artery from the aortic arch is demonstrated.

Evaluation of the lung windows demonstrates no air space opacity, pleural effusion, or pulmonary nodule.

Polycystic kidney disease involving the right kidney is demonstrated. A left nephrectomy has been performed. Multifocal low-density lesions are present throughout the liver, compatible with hepatic cysts. Spleen is mildly enlarged, measuring approximately 14 cm in craniocaudal dimension. The osseous structures demonstrate no abnormality. No mediastinal, hilar or axillary adenopathy is seen.

Impression:
1) No acute abnormality is visualized on the CT chest.
2) Polycystic kidney disease involving the right kidney and liver. A left nephrectomy has been performed.
3) Mild splenomegaly.


STUDY: Paranasal sinus CT
Findings:
Bilateral frontal, ethmoid, and sphenoid sinuses are well aerated with no air-fluid levels or mucosal thickening.

Mild mucosal thickening along the medial walls of bilateral maxillary sinuses. Multiple mucosal retention cysts and/or polyps in the bilateral maxillary sinuses with the largest measuring 2 cm in diameter located along the left anterior maxillary sinus wall. Bilateral osteomeatal units are patent.

The cartilaginous nasal septum is midline. Concha bullosa of the left middle turbinate. There is mild right osseous nasal septal deviation with a 3 mm nasal spur with mucosal contact point with the inferior nasal turbinate.

Orbits and visualized intracranial contents are unremarkable.

Impression:
1) Mild mucuosal thickening of the bilateral maxillary sinuses with multiple mucosal retention cysts and/or polyps. Bilateral osteomeatal units are patent.
2) Otherwise, ethmoid, sphenoid and frontal sinuses are unremarkable.
3) Right osseous nasal septal deviation with septal spur.

And, after all of that, you'd probably like me to explain what I learned. Too bad. I learned almost exactly what you did. There's nothing wrong with my chest, and my sinuses might have a problem, but a "specialist" will have to look to confirm.

So, next up is a trip to visit an Ear, Nose and Throat (ENT) specialist. I've got to make some calls to the hospital tomorrow and see who they have on staff that can poke around inside my head. Hopefully, they won't leave anything up there. I know there's lots of room, but I don't want any rattling.

I've seen the doctor twice in the past two weeks (one for my regular check-up and one for this post-CT checkup). My creatinine was 1.0 and then 1.1 -- both are good numbers. Everything else looks pretty good on my labs, as well.

I think I'll have more to post in a later edition, but for now, I need to cut this one off. Don't want any of my readers falling asleep while they are here.

Tune in next time to find out more about what post-transplant patients are able to do with their vacation time!

Cold

I'm guessing you read the title of this post prior to actually reading the post itself. If so, you may be wondering how I could be cold, in Dallas, in June. Well, I'm not! In fact, for the most part, it's pretty warm. The problem I'm having is "a cold." That's right, I only managed to go 17 months after my kidney transplant before I managed to get sick.

I woke up the last week of May on a Tuesday with a runny nose and a slightly sore throat. I didn't have fever or any other problems, so I was guessing that one of the many things I'm allergic to (see previous post for details) had attacked me in my sleep (that, or Jenny did). By Friday, I had started coughing and producing some of that lovely yellow phlegm that everyone enjoys so much. At that point, I decided it was not just allergies, so I quit taking Benadryl, started taking Mucinex, and called my family doctor for an appointment. I saw her the next Monday, and she gave me an antibiotic and said to try that for ten days. I kept taking the Mucinex (to get stuff out of my chest) and the antibiotic (to kill anything that might try to live in my lungs) for the ten days. That ended last Wednesday, and I was coughing still. I called the nephrologist on Friday (yesterday) and came in for a chest x-ray. Everything is fine in the x-ray, but he wants me to get some blood work on Monday. He also prescribed a cough syrup with codeine to help me. I started taking that today, Saturday, and I think it helps a little.

Wow, that was a long paragraph. This one will be short, to help balance.

That was much better. Let's see, I also saw my cardiologist this week for my regular six-month check-up. She did an echo cardiogram, and said that my mitral valve prolapse is still moderately severe (no change since last time). She said that since I had no change, I would not need an echo in six months, but that I should still come back at that time to see her again. She said she would only do another echo earlier if I had strange trouble breathing.

She also told me that a friend of mine that I met while on dialysis is currently seeing her for her pre-transplant cardiac workup. As a doctor, she did not actually mention this lady's name, but from her description, I was able to figure out who she was referencing. Apparently, this unnamed patient had mentioned that I had a blog and that I had mentioned my cardiologist on it. So, here I am, mentioning her again. I assured her that I've never said anything bad about her, mostly because I really like her and think she does a great job. In fact, if anyone were to ever ask me for a doctor to go see, I'd recommend her. She's very knowledgeable, and always seems to remember at least one non-medical thing that we talked about at our last appointment.

You might think that this isn't special, but let me give you my perspective on things. I saw the nephrologist at dialysis every week, and he barely had time to say hello before he was at the next patient. There was no conversation, and no feeling that he cared how I was doing. Yet, my cardiologist, who I see only once every six months, is able to remember things that I told her that are not medically-related, in addition to being quite friendly and seems to care about my health.

So, long post - but I'm supposed to keep taking the cough suppressant until Friday. If I am still coughing at that time, I have to call the transplant nephrologist back and get seen again. Hopefully it won't be a problem that long.

And, Jenny tells me to have everyone look at the links on the right-hand side of the page. I put one up, today, that links to my adoption story blog. Read it if you like. Or don't, I can't make you (or stop you).

Have a great weekend!!

Another Quick Update

I thought of some more things to say after I posted yesterday. So, I decided to go with a "bonus supplemental post" for today.

First of all, I want to say that I have enjoyed being back at work for the past month. The only problem is that everyone here is attempting to kill me. I work in a cubicle, surrounded by cubicles. The loudest sound I hear is coughing all around me. Don't these people know that I have a suppressed immune system? I am easily susceptible to all sorts of diseases. So, despite my enjoyment of work, I have to try and avoid contact with anyone that is in my area. That way, I can stay healthy. It has worked, so far. We shall see how long that lasts.

The other news I have is good news. After I had my blood drawn at the clinic yesterday, I went back to sit in the waiting area to have my name called to see the doctor. While I was sitting there, I saw a familiar face heading to check out. One of the women that was on dialysis at the clinic while I was on dialysis was leaving. I went an talked to her, and it seems that she had just received a kidney and pancreas transplant. She is blind (or mostly blind) and her son was with her. I recognized the two of them leaving. I was glad to hear that she had gotten a transplant and was doing well. I believe she said she got transplanted about a month ago.

So, good news for the lady from dialysis, and bad news for me if everyone at work keeps being sick. Maybe once all the rain slows down they will start feeling better. I haven't gotten sick yet, and that's good.

See you all next time.

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.

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!

Saturday Update plus 2007-01-29 Lab

Welcome to Saturday. I am going to let everyone know how I am doing today, and also will include my last lab report from my clinic appointments. So, for all of you medically minded readers, you can follow along more closely with my lab reports and see exactly how everything is looking. I shouldn't have another lab report until Monday when I go back to Fort Worth to see the doctor and have my staples removed.

So, more about today. I got a good night's sleep last night, which was nice. I think I am doing much better with the sleeping when I get some good exercise. I walked today for thirty minutes, for a total of one mile. Now that I am able to go for a full thirty minutes, I think I will slowly start increasing my speed/distance. Soon, I should be like a nice, healthy person ... and that will be nice.

The only problem I have been having is heartburn at night. I do not know if it is medication, or if it is what I am eating, or a combination. I guess I will have to let the doctor know about that on Monday. It was particularly bad last night. Luckily, the store-brand ant-acid worked fairly well. I was able to get some sleep, and that's what you need at night.

So, all is well for today. I am glad that I am feeling well and am recovering quickly. Thank you all for your prayers and support. I appreciate everyone looking out for me.

Here is the lab from Monday the 29th:

PROCEDURE	RESULT	UNIT	REF RANGE
[BASIC METABOLIC]
SODIUM	136	MEQ/L	(136 – 145)
POTASSIUM	4.4	MEQ/L	(3.6 – 5.0)
CHLORIDE	101	MEQ/L	(98 – 107)
CO2	24	MMOL/L	(22 – 30)
ANION GAP	11	MEQ/L	(6 – 16)
GLUCOSE RANDOM	84	MG/DL	(75 – 110)
CREATININE	1.0	MG/DL	(0.7 – 1.2)
BUN	12	MG/DL	(9 – 20)
BUN CREAT RATIO	12		(7 – 25)
CALCIUM	10.1	MG/DL	(8.4 – 10.2)
[MAGNESIUM]
MAGNESIUM	1.7	MG/DL	(1.7 – 2.6)
[CBC]
WBC	8.2	K/UL	(4.5 – 11.0)
RBC COUNT	4.26L	M/UL	(4.5 – 6.00)
HEMOGLOBIN	14.2	G/DL	(13.5 – 18.0)
HEMATOCRIT	42.6	%	(40.0 – 52.0)
MCV	100.0H	FL	(80.0 – 99.0)
MCH	33.3H	PG	(27.0 – 33.0)
MCHC	33.3	%	(32.0 – 36.5)
PLATELET COUNT	196	K/UL	(140 – 440)
RDW SD	53.4H	FL	(37.0 – 51.0)
RDW DV	14.5	%	(10.0 – 14.5)
MPV	10.4	FL	(8.5 – 12.0)
SEGS	55	%	(45 – 75)
LYMPHOCYTE	39	%	(20 – 45)
MONOCYTE	5	%	(2 – 9)
EOSINOPHIL	1	%	(0 – 5)
BASOPHIL	1	%	(0 – 2)
SEGS ABS	4.51	K/UL	(2.03 – 8.25)
LYMPHOCYTE ABS	3.20	K/UL	(0.90 – 4.95)
MONOCYTE ABS	0.41	K/UL	(0.09 – 0.99)
EOSINOPHIL ABS	0.08	K/UL	(0.00 – 0.55)
BASOPHIL ABS	0.08	K/UL	(0.00 – 0.22)
ABS NEUTROPHIL	4.51	K/UL	(2.07 – 8.80)
MANUAL BAND	0L	%	(1 – 4)
MAN METAMYELOCY	0	%	(0 – 1)
[PHOSPHORUS]
PHOSPHORUS	3.0	MG/DL	(2.7 – 4.5)
[RT UA]
URINE COLOR	YELLOW
URINE CHARACTER	CLEAR		(CLEAR)
SPECIFIC GRAVITY	> 1.030
URINE PH	5.5
URINE PROTEIN	NEGATIVE		(NEGATIVE)
URINE GLUCOSE	NEGATIVE		(NEGATIVE)
URINE KETONES	NEGATIVE		(NEGATIVE)
URINE BILIRUBIN	NEGATIVE		(NEGATIVE)
UR OCCULT BLOOD	TRACE		(NEGATIVE)
URINE NITRITE	NEGATIVE		(NEGATIVE)
UR UROBILINOGEN	0.2	EU/DL	(0.2 – 1.0)
LEUKOCYTE ESTER	NEGATIVE		(NEGATIVE)
URINE WBCS	3 – 5		(0 – 1)
URINE RBCS	3 – 5		(0 – 1)
EPITHELIAL CELL	RARE
BACTERIA	PRESENT		(ABSENT)
URINE HYALINE CAST	0 – 1

Enjoy!

Long Week

Hey everyone. I realize that I have not posted since last week, and I am trying to make up for that today. I am sitting in dialysis at the moment, and I thought I'd take a minute to update everyone.

This week, I spoke to the GI doctor several times. She ran a test on my gall bladder to see if it was misbehaving. The test said that my gall bladder ejection was abnormally low (around 30%). She advised that I go and talk to a laproscopic surgeon to find out more about my options. I have an appointment next week to meet the surgeon. Maybe I'll find out what is going on from him in terms of my stomach problems.

I came in to dialysis almost 4 kg overweight on Tuesday. I don't tolerate taking off that much fluid, so I had them only remove 3500 cc of fluid. That had me leaving dialysis at 69.9 kg instead of my usual 69.5.

Wednesday night, I woke up very sick. My stomach hurt and I vomitted several times (emptying my stomach). I called in sick to work, and eventually got back to sleep. I was sick most of Thursday morning, but felt well enough to eat some soup for lunch. I fell better now, and expect to go back to work tomorrow.

My weight at dialysis was 70.1 kg when I came in today. That means I only put on 0.2 kg in two days (thanks to being sick).

I don't have anything else today. Please continue to pray that the transplant process will keep moving along. Also pray for my health. Being nauseated is no fun. Thanks for reading and for praying.

My blood pressure is still a little low and my pulse remains a bit high. I see the cardiologist in a couple weeks so I hope to know more then.

Good-bye, and good night.

Bad Tuesday Dialysis

Tuesday night's dialysis treatment did not go all that great. I was okay for a little over three hours, but during about the last fifteen minutes of my treatment, I started to not feel so well. I was kind of light-headed and dizzy, with a bit of a headache, and I felt slightly nauseated. I told the technicians, and they gave me back some of my fluid. At the end of the treatment, I was still not feeling well, so they gave me back some more saline (500 ml in all). I stood up to give my final blood pressure and it was 90-something over 50-something with a pulse around 140 bpm. The nurse told me to sit down and to wait to see if it would balance out.

I stayed at the clinic for another half an hour waiting for my blood pressure and pulse to get within their normal ranges. The blood pressure remained low each time I stood, and my pulse was always much too high (usually in the 130's or 140's). The nurse wanted to call an ambulance, but I had my wife come to dialysis and pick me up, instead. I assured the nurse that I would go to the emergency room if I felt worse or did not start feeling better.

When I got home, I laid in bed for about 30 or 45 minutes waiting to feel better. I finally decided to check my temperature, thinking that I would go to the hospital for anything over 100.4. It turned out that I had 101.1, so we hopped in the car, and we went to the emergency room. I guess I had not been to the hospital with a problem in too long, and my body must have just missed it there.

We got to the hospital around 11:30pm. They got us in to see a doctor right before midnight. We talked about my symptoms and my dialysis, and we figured that a little more saline would probably help with my light-headedness. So, they gave me 250 ml of saline, and I laid on the short, uncomfortable ER bed for another hour. When the nurse came back, I was feeling less dizzy, but now I was much more nauseated than when I had come in. The doctor gave me some nausea medicine and let me lay there for a while longer.

He finally came in to say that he could either send me home, or admit me to the hospital for observation. He said it would be observation only has he had no idea what was wrong with me. By this point, I was feeling mostly better, albeit tired, and was ready to go home. I told him to just send me home, and that if I got to feeling worse after having some sleep, that I would come back to the ER to see him.

I went ahead and went to work today, even though I was a bit tired. I did not have any dizziness symptoms, though there was some nausea. The nausea did not bother me as it is not infrequent in the mornings for me. I took my temperature when I awoke and after I got home, and both were normal. Even now, right before I typed this, I was only up to 98.8 degrees.

Please pray for me that Thursday night's dialysis treatment will go better. I think I am going to ask them to raise my dry weight another half a kilogram to 69.5 kg. That will mean that I get to keep a little bit more fluid, and hopefully will help prevent me from having to take another trip to the ER. I appreciate and need your prayers. Thanks a lot!

New Fistula Follow-Up

I just got back from the vascular surgeon. Today was my one week follow up for the new fistula that he put in (back on Monday, 4/3/06). He unwrapped my bloodied bandages, and felt around my bruised skin. He then put the ultrasound wand over the fistula (which is a few centimeters above the incision) and took a look inside. He said that he liked what he was hearing and seeing, and he said that the fistula looks like it is doing just fine.

I am scheduled to come back in two more weeks (three weeks after the surgery) to have my arm looked at again. He said that at that time he may remove the stitches (depending on how well I am healing). It is not a problem that my incision is still leaking a little blood. In fact, it’s just part of the healing process, and my arm is healing fine. It takes several weeks for a surgery like the one I had to heal completely.

So, all-in-all, life is going well. My arm is not quite stretching out completely without pain, yet, but that is part of the healing process. My dialysis has been going mostly okay recently. The only exception was a week or two ago. I had what seemed like a good treatment, but I was awake for the next hour feeling hot and nauseated. I haven’t had that problem again, and I think it may have been caused by taking off too much fluid. So, I am sticking with my 69.0 kg weight and hoping that everything works from there.

My work life is going well, too. The person that helped me get my job left the company on Friday, and I am slowly working my way in to covering his old duties. He worked on many things in a lot of areas, so it may be two or three weeks before I feel competent. The good thing is that this job is full of challenges, which is what I really enjoy.

I continue to desire your prayers this week. I have had two family members and two friends get their blood tested for kidney transplantation. The transplant coordinator should contact me soon to let me know the results and have me think about picking someone out to be fully tested. Please pray that God will show me the right person to have tested and that the testing process goes quickly and smoothly. Also pray that I will continue to do well while I am on dialysis.

The pastor at our church spoke last Sunday about bringing glory to God through our lives. He said that glory is just raising the opinions that others have about someone or something. So, I want to live my life, kidney disease and all, so that it raises other people’s opinions about God. I want to be a good example of a Christian. Please pray with me that I will continue to show those around me how wonderful God really is. Thanks!

Gastritis

I went to the GI doctor yesterday afternoon to have an endoscopy. The purpose of this test was to hopefully find out what is causing me to feel nauseated on a regular basis. The doctor put me to sleep, and slipped a scope down my throat to look at my esophagus, stomach, and upper intestines. She found a few things down there of interest.

First of all, she said that I have gastritis. WebMD defines gastritis as: “an inflammation, irritation or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic)”. She said that this might be the main problem, and told me to continue to take my Nexium. She took a biopsy and is sending it to the lab for more information. She also found a node at the bottom of my esophagus, and sent a biopsy of it off, as well. And, finally she said that I have a hiatal hernia. WebMD says a hiatal hernia is: “A hernia occurs when tissue from inside the abdomen bulges out through a weak spot in the muscles of the abdominal wall. When part of the stomach bulges upward out of the abdomen and into the chest cavity, it is called a hiatal hernia”. It seems that lots of people have this type of hernia and never know it because they never are looked at. She said that it is not causing any problems and probably will not cause any in the future. So, in conclusion, I get to add gastritis to my list of infirmities (yippee).

I have dialysis scheduled again tonight. I did not bring any emla cream with me today. I want to see how the treatment goes without it. I am not a big medication fan, so if I can do without it, I think I might just skip it. Saturday, my fistula started to hurt, so the technician stopped the machine and moved one of the needles around. She got to it pretty quickly, so I did not have any bruising. It is always important to complain when there are problems. I just have to remember that next time. I should get my chest catheter flushed today. They said that they are only going to look at it once a week now that they aren’t using it. I hope that it will soon be removed.

I sent my cardiologist a list of my blood pressure for the last two weeks. She had upped the dosage on one of my medications, hoping to lower my pressure. That did help some, but not enough. So, she is adding a third medication to my hypertension list. I am now taking 5 mg of Norvasc every day (at least for the next two weeks). I am supposed to show her my pressures again and then we will see where to go from there.

Finally, I got a call Monday afternoon from the pre-transplant coordinator. I am officially on the kidney transplant list for the next year! It seems that I passed all of my tests, and that I am on the list. I guess the insurance company re-evaluates you on a yearly basis, so you basically have to have your status as someone that needs a kidney renewed every year.

Being on the transplant list is great news! I have the packets of information, and I just have to go to the Post Office to mail them out. You should be getting them (and a cheesy DVD) in the next week or so if you volunteered to get tested.

Thanks for coming by to read!

Finally Back to the Fistula

I had dialysis Tuesday night. The doctor had said last Thursday that he wanted to start using my fistula again (at least with one needle). So, I got to do my dialysis with the blood being drawn from my arm and put back into my chest (via the catheter). The doctor came by and he said that everything looked good. He wants to use two needles on Thursday (and no catheter!). He will have them do that for a week or two and then if everything is okay, they can schedule to have the catheter removed. I am really looking forward to having it taken out.

I used the emla cream on my arm last night to deaden the needle site. It works just like it says. The pain was very little, and I think I will probably continue to use this cream for a while. Even though I only had one needle, and it was small, I think that the cream will be much nicer than just bearing with the pain each week. I guess that since it was a small needle, my arm healed much better than it used to.

I have been having a few problems recently. There is still blood in my urine (since Sunday morning), but there is not any pain with it. The nurse at dialysis said that if it continues, then they will need to check my hemoglobin levels to make sure I am not losing too much blood. But, my polycystic kidneys can cause bleeding, so they are not too worried yet. I won’t be worried unless it lasts for a while or if it starts to cause a lot of pain.

I went and saw a doctor of gastroenterology yesterday. I am hoping that she will be able to help me with my morning nausea that I’ve been having since this summer. She took my medical history and set up a few tests. She wanted some blood work (which I was able to get at dialysis last night). She also wanted an ultrasound of my liver and gall bladder (which I got this morning while having my kidney and abdomen scanned for the transplant evaluation). She also wants me to have an endoscopy, which is where a camera takes a look at your esophagus, stomach, and upper intestines. I have that appointment scheduled for Monday. It should be a lot of fun. I get to take a little nap. I still have to find a ride home, but I’m working on that. I have a few people that I can call.

I had an appointment with my family doctor today. The GI doctor had noticed some white pus in my throat, and she wanted me to get tested for strep. The doctor ran a swab today and it was negative for strep type A. She has to send it off to the lab to be run to see if I have anything else that could be causing my problem. She prescribed me some antibiotics to take for the next 10 days, so if it is bacterial, then that should clear it up. I also asked her for the name of some genetic counselors that Jenny and I can talk to before we decide what to do about having children. I already know that I have polycystic kidney disease (which is autosomal dominant), and the cardiologist that I saw for my transplant evaluation wants me to get tested for Marfans. (I have an eye doctor appointment this afternoon, I will ask him to take a look at my eyes and see, and apparently there are some signs of Marfans that show up in the eyes).

So, that’s it for now. I should be done with my chest catheter in the next couple of weeks. I will be taking antibiotics for the next ten days to clear up my throat. And, I think I am closing in on the finish of my transplant testing. Thanks for reading.

Time for an Update

It has been a while since I have written anything, so I figured that it was time for me to update everyone on what is going on. Last time, I gave everyone my January lab report that I got from dialysis. And of course, previously, I had mentioned that I started my transplant evaluation two Mondays ago. They have drawn a total of 22 vials of blood (so far) in my evaluation, and I am sure that there is more to come.

I went to see my cardiologist on Monday afternoon. My blood pressure has been quite high at dialysis since I was taken off of the Norvasc and put on the Toprol XL. Now, my heart rate was fixed by the Toprol XL, so I am grateful for that. But, I need my blood pressure to be lower so that I do not have a stroke or a heart attack. So, the cardiologist upped my dosage of Diovan from 160 mg / day to 320 mg / day. The Diovan has not had a chance to get into my system (at the higher level) yet, so I cannot report how well it is working. I am supposed to track my blood pressure for two weeks and then let the cardiologist know. If it is going well, then I am okay. If not, then it is time for more medications for me!

I have the “Living Donor Transplant Applications” sitting here on my desk. I am going to be looking for addresses to send them out to those of you who have asked if you could be tested for giving me one of your kidneys (thank you!!). I also have a DVD from the transplant people, which I may or may not be able to send out copies of. Be looking in your mail (or maybe e-mail, if I can convert them to an electronic format) in the next week, and be sure to send them back as FAST as possible.

Let’s see … in other news, I will start using my fistula again on Thursday. I have not used it in about seven weeks, which should be long enough for it to heal. The dialysis clinic said that they will use the small (17 gauge) needles so that there won’t be too much stress placed on the vein. I do not know if they will use one needle or two; I guess it just depends on what the doctor indicated in the chart (since he mentioned both at different times). I have not seen the doctor this week, so he should be there Thursday and be happy to see my fistula in use again.

I have been having stomach ache problems again lately. I thought that the Nexium had helped, but I seem to be having problems again. I am waking up not feeling well several days a week, which is certainly no fun. So, I have an appointment with a GI doctor next week, and hopefully she can find out what is wrong with me and offer some helpful solutions.

Please pray that my transplant evaluation will continue to go well and that they will find everything that they need. Also pray that I will not have to live with my stomach problems for much longer. It is all in God’s hands at this point.

Some of you are receiving this post by e-mail today and have no idea why. I had a few people in the orchestra and in my old ABF class mention that they would like to know how I am doing. So, for today only, I am sending a copy of this post out to those two group lists. If you would like to receive all of my updates via e-mail, then please REPLY to me and let me know. I can subscribe you to all of the new posts. Or, if you would like to just read these posts on the web, then go to http://nmccart.blogspot.com/. You can also subscribe to the ATOM feed at http://nmccart.blogspot.com/atom.xml.