Tuesday, June 28, 2011

Reminder

Here's my occasional reminder...

Please remember that the things I write about in this blog are a direct reference to my personal experience with polycystic kidney disease. How my body reacts to medicines, treatments and care plans are mine alone.

How I progress through this disease is solely about my body. How any other patient might react to similar treatments and circumstances is a purely individual thing. I am simply relating to others my singular experience.

Any other PCKD patient could have a wholly different experience that in no way resembles the journey I am taking.

Please, always consult with a specialist to determine the treatment that is right for YOU! Only your doctor can determine what your body needs to best fight this disease and lead you to the best possible outcome.

Thank You!

ScottW

28 June 2011

Another  downward turn the last four days.


My little break...such as it was...is now over. A strong return of the major S/S's to their increased level was evidenced on Saturday morning. Let's start with edema.


I told you earlier that the edema was diminished in the mornings and bad at night. On Saturday the edema never went down. My feet were swollen and ugly all day. Since then they decrease about 50% (from their worst), but my feet are quickly swollen not long after waking. When my feet swell the skin gets tight, itchy and incredibly uncomfortable, and even painful when walking. Even when my feet are elevated the swelling does not decrease, yet the pain and discomfort persist; so much so that my calves on both legs become painful from resting against the recliner foot rest.
The other day I absentmindedly rested my right leg (on the calf) over my left knee. I was somewhat comfortable for however long it was there until my R leg became painful. I realized my mistake in keeping the leg in that position. I looked at the calf and say a very visible depression in the skin that looked like my kneecap. It was about 1/8" deep, and the impression stayed there for over an hour before finally rebounding. I keep forgetting to get comparative pics to post on here. i'll try to remember to get it done in the next day or so.


Next, my nausea. Ick, Ick, Ick! I've come very, very close to emesis a number of times since Saturday. The promethazine kicks in just in time. I'm talking feeling like it's time to go kneel before the great porcelain goddess to offer up what isn't in my stomach, and then the anti-emetic takes hold and the nausea is gone. I've come that close. No fun there.


Because of taking the Promethazine, my napping has taken a predictable turn for the worse. The last four days my naps have been, in order, (1) Three hours, two hours, (2) four hours, 45 minutes, (3) three and a half hours, one hour, (4) four and a half hours. This has been on top of a minimum of 7 hours of restless sleep. Speaking of sleep, it has been poor, to say the least. A lot of the time I'm just not feeling well so my sleep is not good. My dreams have been OK; I am controlling things just fine; I am just restless from the physical nature of what's going on.


Next, the mid-back pain. On Sunday afternoon I had a sharp increase in pain in my mid-back area, over the kidneys. This increase led the pain to go from present and very uncomfortable (I'd gotten used to that level of pain) to downright painful. Plus, the pain is referring around both sides to about the middle of the rib cage. I don't think the pain is from any spinal misalignment because on palpation, the pain is worse than ever. Plus, the pain does not go away when laying, sitting, etc. It is constantly there. On a pain scale I'd estimate that things went from a three to an eight.


My headache returned to its elevated normal of about 9.5. No surprise there. I'm continuing to control it with T3 usage. My average daily usage on the T3's is now 3.92 (as of last month's total usage).


My urine has been exceptionally odoriferous. Lots of cloudiness, too. No pain on urination which might indicate a kidney stone (thank goodness!); but the volume is never consistent, either. Plus, there are two things going on with my bladder. One, it feels full every time I urinate; but only about 33% of the time is the flow indicative of a full bladder. Two (and I'm told by my doc that this is normal for advanced PCKD patients), I have to always wait to finish urinating. My bladder may not be done even though the obvious flow has ceased. So, I wait to know that the flow has stopped. Doing otherwise has led to leakage that I cannot feel is happening. I don't know about this in female patients; but amongst male PCKD patients, this is a common occurrence. My advice...just wait to zip up until you're sure things are done!


I am often asked if what I share on this blog is embarrassing in any way. I tell anyone asking that there is no room for embarrassment. In order for me to provide an accurate, truthful account of this journey, I must set aside any embarrassment. I cannot do my readers and fellow PCKD patients any good if I omit certain facts that many others would consider too personal. I have not found a similar account of PCKD, and I strongly feel it is vital to provide as much fact and insight as I can.


Anyhow, I'm tired, so I'll wrap this up.


Good Health to All!


ScottW

Friday, June 24, 2011

24 June 2011

The past two days have been interesting.

Nothing terrible, mind you; just interesting.

My headache has been a manageable 8--I know...what a surprise there!

My appetite remains poor at about 1.5 cups/day. fewer and fewer foods are appealing as each week passes by. Few snacks are palpable anymore. Even fewer standby meals are appealing. A lot of the time I'm eating because I need to.

Vertigo continues to be an ever present issue. I awoke with a mild case yesterday, took some promethazine, and felt the usual knot in my stomach go away for a few hours--though the vertigo itself never left. I went to see a movie last night and in my walking had to steady myself numerous times with my cane in order to keep my feet.

The edema in my feet has been going from OK to really bad. I usually awaken with minimal swelling in my feet and legs; but by the end of the day my feet are horribly swollen with edema. I'll put up comparative pics of this in the next day or two so you can see how bad the edema gets. Luckily, the swelling usually reduces by the time I awaken in the morning. When it becomes severe without reduction then I'll have a sure sign that my kidney's are in serious trouble.

Exhaustion continues to plague my mind and body.  My sleep is now all over the place because of the multiple naps I take every day that range between 30 minutes to three or four hours. Restlessness is a continual pattern in what sleep I get. One thing I've come to do before sleeping is to avoid negative images that might disrupt my ability to get peaceful sleep. I'm talking TV shows, bad news on the Internet, etc. For me, if I go to sleep with fairly fresh images of death, mayhem, emotional trauma, or even images of things that don't normally scare me, then my sleep is restless and my dreams uncontrollable. Plus, when I awaken from a night of disturbing dreams, my ability to keep my mind in a good place becomes compromised, and I struggle mentally far more than I should. So for me, no more negative images before bed.

That's it for now. I feel a nap coming on, which means I need to wrap this up.

Good Health to All!

ScottW

Tuesday, June 21, 2011

21 June 2011

That bad stretch is finally over!

What an awful string of days...definitely not a thing to repeat. Over the last five or six days (or however long it was) I did:
*a lot of sleeping
*had tons of horrific vertigo and terrible nausea
*dealt with my headache being uncontrollable for several days
*ate very little for about three of the worst days
*and, strangely enough, saw my edema drop to next to nothing all the while.

I did nothing in particular to get the S/S's to ease up; they just did it on their own. It has definitely gotten my attention, though. If it happens again, I will seriously consider starting dialysis. What happened way so far beyond normal that I am greatly concerned.

I've got my next nephrology appointment coming up on July 6th. Assuming I do OK between now and then, I'll be telling my doc everything that's happened. Based on his response, as well as the results of my lab work, I'll decide what to do next. I will absolutely let you know what is decided.

That's all for now. I don't have a lot of detail about these last days because I just don't remember much beyond what I've already written.

Let's hope the next while is relatively "normal" once again.

Good Health to All!

ScottW

Sunday, June 19, 2011

18 June 2011

Terrible day.


Woke up with unbelievable vertigo that was so bad I can barely walk--even when leaning heavily against walls.


The vertigo is there whether or not my eyes are open.


Accompanying the vertigo is intense nausea and a knotted stomach.


After awaking to everything spinning, I ended up restlessly napping twice for a total of about six hours.


I've eaten very little because of this.


Like I stated earlier...


A terrible day.

Tuesday, June 14, 2011

14 June 2011

Just a brief update today.

The last three days have been really bad. I've slept...a lot.

My headache has been uncontrollable; and my whole body has been full of aches, knotted stomach, lots of mid-back pain, and increased nausea.

Food intake has plunged as a result. Any food only exacerbates everything I've been feeling, so I am naturally hesitant to feed myself.

When I am awake I've been doing far less than normal. It even seems like movement of any measure makes me feel worse.

I don't know why the sudden onset...I just hope this doesn't last much longer.

Good Health to All!

ScottW

Monday, June 13, 2011

13 June 2011

Since my last regular entry, things have been both OK, and downright bad.

On the plus side I've had, I think, three days that were OK. Most of the major S/S's were diminished (except for the headache!), and I felt a bit better overall. I still hardly ate anything, but at least I didn't feel miserable for a little while. These days are always welcomed, and I never take them for granted.

On the downside, when the major S/S's have been prevelant, they have been kicking my butt.

...about 30 minutes after writing the above, I decided to stop for today. I haven't been able to put together a coherent blog entry because I'm just not feeling good in any way. This has been going on since last night.

So, That's all I'm going to write today. Next time will be better.

Good Health to All!

ScottW

Thursday, June 9, 2011

08 June 2011 (Fistula Follow-Up)

I had my follow-up with the vascular surgeon today.

Well, it wasn't actually the surgeon. He does surgeries on Wednesdays. I saw his P.A. and I have good news.

The AV Fistula is ready for dialysis a whole two months early! He stated that my overall health, age and dedication to doing the prescribed tourniquet therapy all contributed to the early time frame. Also, the fistula will continue to mature a bit more, but I no longer need to do the exercises.

The ultrasound mapping was fantastic. The images clearly showed a nice big super-vein along the length of my forearm that had considerable blood flow and a strong, healthy sound.

Also, when I am to start actual dialysis, I need to return to the vascular surgeon's office so they can clearly mark the length of the vein. Further, as the vein finishes maturing, I will be able to not only see a lot of it, but will also be able to easily feel the vein itself so I can identify cannulation points by touch.

So, that's my report. I no longer need follow-ups with that doctor (besides marking the length of the vein). Great news all around. This also means that dialysis can start immediately, should the need become pressing.

A great news day for me!

Good Health to All!

ScottW

Sunday, June 5, 2011

05 June 2011

Wow...Lots of icks in the days since my last report.

To start, lets talk about edema. I had several concurrent days of my feet looking like Hobbit feet, but with painful swelling and LOTS of pain on walking. The edema seems better [for a while] keeping my feet up. However, I've also had times that my feet have swollen when they are elevated. Today the edema is nominal for the first time in a week. However, both my feet are painful just about all of the time now. I don't know if this is permanent; but I guess we'll be finding out very soon!
Additionally, the edema has been present up past the knees, and in the hands...especially my fingers.

Next, let's talk about the ongoing headache. Now just short of 19 months in duration, the headache has continued its increased intensity; though the sharp pains have backed off a bit (thank goodness!). For the first time in this whole thing, my daily T3 usage has upped to an average of 3.75 doses/day. This includes several days of taking 4-6 doses which only just kept the pain under control. I continue to use my TMD occlusive devices just to eliminate the possibility of S/S's of the TMD rearing up; but so far, I've only had a couple of days with TMD complications on top of this damned headache.

My appetite has been mixed once again. I'm getting hungry a lot (as before); but that hunger quickly morphs into intense nausea. Oftentimes when I eat these days I end up with nausea anyway...a no-win situation. Plus, my range of foods that are appealing is shrinking again. Right now I continue to crave protein (meats--not legumes), but only tolerate fresh veggies. I can't stand pastas, right now, but will eat some breads. Sugars are becoming unpalatable--even drinking Coca~Cola is becoming a chore. Salt in any amount seems overwhelming to my palate. I avoid fresh fruits because they just aren't appealing. Potato's seem to be holding out for me; though too much and they become inedible for me. Dairy products seem to be consistently appealing as well, though my taste buds are becoming tired of these in large amounts. All of this leaves me with a smaller and smaller pool of foods from which to eat--well, at least, eat as little as I do these days.

While my skin does not yet smell of ammonia, I have definitely noticed that my skin is becoming clammy and feeling dirty a lot sooner than even a month ago. Where before I could go two of three days between showers (simply because I'm not doing much; not generating sweat, dirt, etc), I now find myself wanting to get clean after just one day. I don't always act on this just because I'm feeling lousy, or because no one is home and I'm wary of the increasing chance of getting bad vertigo while in the shower and really don't want a ground-level fall with no one else home.

Speaking of vertigo, it marches only as relentlessly as my headache. I never know when it will strike. There have been days where it has been only minor all day, only to suddenly increase its intensity, and I have to grab something to stay on my feet. When out walking, my cane is increasingly keeping my from falling a number of times each outing. The last few weeks even a minor raising of my head [while standing] has caused intense vertigo. This is getting progressively worse as the disease runs towards its conclusion. As far as waking to the room spinning, it is still happening, but only occasionally. However, I am getting immersed in dizziness even when sitting in my recliner--and for no apparent reason. THAT one really sucks. I literally grab the arms of my recliner, keep my eyes open (because closing them only increases the sensation), and just hang on until it passes. NOT fun!

My urine has been consistently cloudy, and extremely odoriferous. It is especially so when I've had a lot of edema. Yes, of course it's tied in to the edema; I just thought I'd throw out that info. In addition, I have remained correct in the decrease of overall urination (volume and frequency). The decreases have now been going on for about three weeks.

My sleep and naps remain terrible. Exhaustion is now a way of life...unfortunately. Naps this last week have averaged four hours in length. So, coupled with my nightly sleep average, I am now getting about eleven hours of sleep per day. For someone who for years functioned extremely well on 5-6 hours per day, the current eleven hours feels like I am wasting an incredible amount of time, which id extremely frustrating to me. On the other hand, I'm not really doing much these days, so I really shouldn't be worried or frustrated. It's just a thing I must mentally deal with.

My state of mind remains very good. I continue to look forward to a post-transplant life; but I do become impatient for it to get here. My back injury and subsequent surgery and recovery taught me a whole lot about state of mind. As I've mentioned before, I apply those lessons every day, and endeavor daily to avoid the pitfalls of depression, discouragement and hopelessness. No bueno, my friends. Those are NOT places I am willing top go!!!

On that note, I'll end this entry.

I've got the two month follow-up with my vascular surgeon on Wednesday. I'll tell you all about it!

Until next time...

Good Health to All!

ScottW