Saturday, January 15, 2011

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)!

Friday, November 19, 2010

2010 Top Kidney Disease Blog Award

It appears that I have "won" an award from [redacted]. I'm not quite sure what it all means, yet.

The email that I received states:
As a website dedicated to help those consider a career as a certified nursing assistant, we only provide the best information available. Whether it's a resource that helps patients cope with their illness, or provides ways to live healthier, we feel that it's necessary for those seeking to obtain this information. This is why we've featured your blog, as it is one of the best to teach our readers.

I realize that not very many people will really find this interesting. I like to see that people (or groups) have been reading my blog and actually found it helpful or at least useful to someone.

I'd like to publicly thank the readers from that website for their award. I hope that they are able to find the information that they are seeking from a patient's perspective.

In other news, I realize that I never posted about my October transplant appointment. I'll have to fix that (but not today).

See you next time!

Sunday, October 10, 2010

September 15, 2010: Cardiologist Appointment

Hi there, faithful readers (or those of you that just happened to stumble onto this posting). Today is the updated that my normal readers were hoping to see last Sunday. Unfortunately, my free time in the morning was cut an hour short, so I was not able to get online and write up my explanation from my latest cardiology appointment.

I saw my "new" cardiologist about a month ago. I say new because the cardiologist that I used to go see has retired from practice. I think she wanted to spend more time with her family (of which I am in favor). So, the previous visit to my cardiologist, back in June was to check my heart and my mitral valve to make sure everything was still working correctly. You can read that post here: Cardiologist Appointment - June 15, 2010. The doctor thought he saw some disturbing signs, so he asked me to come back in three months, instead of my typical six, to have my heart reviewed again.

The post received a few questions, which I will endeavor to answer below. I did not know the answers myself, so I just asked the doctor to help me out :)

1) Please Explain Ejection Fraction
The ejection fraction is the volume difference between heartbeats. Normally, you would expect to see an ejection fraction of 60% to 65%. My current rating is between 55% and 60%. I asked, and the doctor said that an ejection fraction of less than 50% was very bad, and that they would want to get me into surgery if that were to happen.

2) What is the Thickness of Your Mitral Valve Leaflets?
Normal mitral valve leaflets (shown in the diagram at the bottom as MV) are usually around 5 millimeters thick. My leaflets are slightly thicker than normal, but nothing to worry about at this time.

3) Do you have any enlarged ventricles or atrium?
No, at this time my ventricles and atria are both normal sized. This question is important because the mitral regurgitation can cause the heart to expand in size, over time. If you heart starts to get larger, it cannot be made smaller again. So, part of what they watch for is to make sure that your heart is not getting too big and that your ejection fraction stays within safe tolerances.

4) Please explain regurgitation and prolapse (in regards to the heart).
Regurgitation is blood flowing the wrong way in the heart. In the diagram at the bottom of this post, you can see a rough drawing of the heart. Blood is supposed to flow from the Left Atrium (LA) to the Left Ventricle (LV) and then out of the Aorta (AO). Regurgitation is the arrow that shows blood flowing back across the Mitral Valve (MV) from the LV to the LA.

Prolapse is simply the valve action going back up into the Left Atrium (LA). Normally, your mitral valve (MV) should allow blood flow downward (in the drawing) from LA to LV. The valve leaflets should stop the blood from flowing back up. Mine do not do that quite as well as they should. This reverse action causes the leaflets to be a little spongy, and to eventually wear out.

The doctor is watching the size of my heart as well as the ejection fraction that the valve is allowing. When they start to head toward a more dangerous range, then we will start talking about surgery.

5) What's your current status, then?
OK - big question! I'm still doing fine. The doctor said that he did not see a recurrence of the problems that he thought he noted in June, so I will not see him again for six months (this was my normal schedule). I'm not in perfect heart health, as my Ejection Fraction is down to 55-60% instead of 60-65%. But, until there are any changes, then I will keep my ribcage intact!

Thanks for reading today! The drawing below is my sketch based on the sketch that the doctor gave me at my appointment. Please try an pretend that it looks like a heart.

My next post should be about the post-transplant follow-up that I had on October 7. If I'm lucky, I will write it up next Sunday. See you later!