Saturday, August 31, 2013

30 August 2013


Alright, a little more news today; but only after I give you my dialysis weights...

22 Aug 13
Starting Weight:  106.5 Kg
Ending Weight:  104.2 Kg
Water Removed:  2.30 Kg

24 Aug 13
Starting Weight:  106.8 Kg
Ending Weight:  104.1 Kg
Water Removed:  2.70 Kg

27 Aug 13
Starting Weight:  107.1 Kg
Ending Weight:  104.3 Kg
Water Removed:  2.80 Kg

29 Aug 13
Starting Weight:  107.2 Kg
Ending Weight:  104.1 Kg
Water Removed:  3.10 Kg

*Remember, one Kg (kilogram) equals 2.20 pounds. So, like on the last Tx, 3.10 kg equals just over 6.6 pounds, or, approximately 3/4 of a gallon. This is what is being retained in my body in spite of continued urine production.

My top weights continue to be elevated; but this really is no surprise. With as much as my flanks hurt, and my urine output decreasing, my body just can't filter it out. The increasing water retention will only get worse until my kidneys are removed; at which time my fluid intake will be sharply curtailed, and closely monitored.

This past Wednesday I had my dental re-exam. Nothing has changed since last January [when I had the initial exam]. The dentist asked about whether or not I wanted to do work on the one tooth that is hollow, and I stated I just want it pulled because I have some room for my bottom teeth to spread a bit; and besides, I really don't want to go through the pain and multiple procedures to save the root and do a build-up. The doc had no problem with my decision.

So, starting on 11 Sept, I will have work on the R side of my mouth done--a few cavities and the extraction. Then again on the 18th for the L side cavities. And finally, on the 25th for the deep cleaning. I am so glad this is getting done!

After the dental is finished, I'll schedule the surgical consult with my Transplant Team, and we'll get the Nephrectomy scheduled at that point.

Things really are moving along, now!

The nausea is up and down the past week. I only had a Zofran injection at dialysis once--a nice change of pace. However, I have been awoken a couple of times on my off days and had to take Promethazine to get the nausea under control.
Overall, not a bad week for this.

The headache keeps going...
I am trying to do without any pain meds for my headache on my off days. It  isn't a fun proposition, but I just want a break from the yucks of constantly being on T3. The last few off-days I have averaged only two T3's. By the way, the headache is now at 46 months and counting.

I forgot to mention...At the Transplant Team appointment, they ordered up a new test. This was only recently added for male patients over 50...a PSA blood test. This is a Prostate Specific Antigen test that measures the health of the prostate gland. In the lab results, anything  below 4 ng/mL is considered good. Higher numbers might reflect problems with the prostate, and therefore require additional testing. Anyhow, I had this drawn on yesterday's dialysis. I should know the results in a few days.

I've already referred to my bilateral flank pain. It has been quite pronounced this week. Sitting still for four hours of dialysis has been difficult, at best. I stretch my back as well as I can [from a sitting position], and just try to sit so my lower back isn't against the chair. It's quite fatiguing, actually. Then all day today, my flanks have become progressively more painful. I am NOT having fun with my back!

My energy this week has been poor, at best. My sleep is, well...it just is. Ranging from poor to unrestful, I am waking more often than not completely exhausted. The Transplant Team nephrologist stated that the energy drain would only increase until the kidneys are removed. So, I will fully expect my energy to get far worse in the next couple of months.

Speaking of sleep, my typical pre and post-D sleep is at about 17 hours. I still get in a few short naps, too. My one day per week of regular sleep is averaging about ten hours, plus naps. And when I'm awake, I am often yawning, and feeling sleepy. This again goes back to my energy level.

Well, that's all for now. I have to be up in four hours for the last dialysis of the week; so I'll be on my way.

Have a fantastic week, my friends!

Be outstanding in everything you do!

Good Health to All!

ScottW

**At dialysis today (Sat, 31 Aug) I was informed that my PSA results came back and I am at an extremely healthy 2.62 ng/mL!  
The Transplant team will be very pleased with that result!

Monday, August 26, 2013

26 August 2013

Well, this afternoon I had my one year follow-up with my Transplant Team at Intermountain Medical Center. I met with my Transplant Coordinator, the Dietitian, the Social Services Rep and a Transplant Team Nephrologist.

The meeting was all about seeing me, getting my thoughts on how things are progressing towards my transplant, and essentially assuring that the entire team is on the same page with my current health/treatments/time frames, etc.

I was also given a notebook with information about the actual transplant process, the after-care, and answers to loads of questions. This notebook isn't generally handed out to patients this far ahead of a transplant, but because I am obviously working towards the procedure, and because I like to educate myself ahead of time, my Coordinator thought it would be appropriate to give me the info now. (See...yet another reason to be proactive and show your transplant team that you're following instructions and transplant prep!) So, now I have an invaluable resource to peruse over the next few weeks. I will check with my coordinator to see if I can post some of the info on my blog once I'm on the Active List.

There was no blood draw, nor any other tests. The outcome was that I am doing great,
I'm eating properly, I'm in the right mindset and am conducting my day to day health
with the goal of transplant in mind. The Transplant Team had no worries whatsoever about me! Awesome!!

I was also given two pieces of info today...

1) The current wait time for a transplant is about two years. This can change, of course, due to other lists in the State, other factors having to do with cross matching, etc. It's all pretty technical, and even I don't understand everything yet--though, the Transplant notebook I was given today should help explain things better.

2) The nephrologist stated that of all the renal diseases that exist, patients with Polycystic disease have, on average, far better transplant outcomes than any others.
For me, this is fantastic news! Yet one more reason to keep my mind in a good place; knowing that my outcome is likely to be better than even I expected!

So there you are. My transplant is on track, and as soon as the dental clearance is done and I'm healed from the double nephrectomy, I'll be placed on the Active List.
Things are moving forward indeed!

Last entry I noted that I had additional blood work done. Here are the latest numbers...



*Albumin (20 Aug):  4.60 g/dL (No Change from 16 Ju6)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (20 Aug):  11.4 g/dL  (+0.40 g/dL from 06 Aug)
  (A Measure of Anemia)

*Ca Corrected (06 Aug): 9.50 mg/dL (-0.10 mg/dL from 02 Jul)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (06 Aug):  4.20 mg/dL (- 0.2 mg/dL from 02 Jul)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (20 Aug):  175 pg/mL  (+49 pg/mL from 16 Jul)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (20 Aug):  4.2 mEq/L (-0.10 mEq/L from 16 Jul)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (08 Aug): 1.56   (+0.14 from 02 Jul)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher

The big news on these labs is that, after a year plus on dialysis, my PTH has jumped into the target range! I didn't do anything different, my body just finally retained the proper amount of this essential, naturally occurring hormone. Now, if only the hemoglobin would get in line, too...   ;o)

That's all for today. I really only wanted to highlight the Transplant Team follow-up and my latest labs. I will likely be getting to another entry later this week.

Until then, keep a smile on your face, a good thought in your mind and carry a lite heart!

Good Health to All!

ScottW

Wednesday, August 21, 2013

21 August 2013

A bit of great news for you today...

This next Wednesday--28 Aug--I will be getting a re-exam for my dental work, then will schedule all the work that needs to be done. By mid-September, all the dental should be finished, and the clearance letter written! (Yay!)   After that, I'll schedule a surgical consult for my double nephrectomy, and will, hopefully, have my kidneys removed by mid to late October; and be eligible for the active transplant list around the New Year.

By the time I am on the active list, I'll have accumulated over a year on the inactive list which will bump me up X number of places. Now that I have a clear time frame, I'll also begin asking for potential donors.

Under my transplant 'Umbrella,' any donor will be tested free of any charge to their own finances. Any travel involved (and food, lodging, etc.) is the responsibility of the donor. If a living donor is chosen, again, all medical expenses will be covered 100%, while travel costs are not. For your own Transplant Umbrella and donor coverage, be sure to consult with your Transplant Team; only they can answer that question for you!

So, the next step is about to begin...

Dialysis Weights:

15 Aug 13
Starting Weight:  106.3 Kg
Ending Weight:  104.2 Kg
Water Removed:  2.10 Kg

17 Aug 13
Starting Weight:  107.0 Kg
Ending Weight:  103.8 Kg
Water Removed:  3.20 Kg

20 Aug 13
Starting Weight:  107.2 Kg
Ending Weight:  104.1 Kg
Water Removed:  3.10 Kg

As you can see, my wet weight is high every time this past week. I'm not the least bit surprised by this because my flanks are killing me. Though my urine production is consistent, I think I've got more cystic growth in and on both kidneys. The comfort I had last week is completely gone. In fact, at dialysis this morning, I went in feeling OK. Within an hour of starting I could barely sit still because of the sudden onset of intense bilateral flank pain. Then all day afterwards, I have been in pain, as well; including during my nap. NOT a fun day!

I don't remember if I told you that on Monday--26 Aug--I have a follow-up with my Transplant Team. I'm expecting to do labs, talk finances, do some sort of exam(s), etc. It will only be an hour long appointment, so things shouldn't be too in-depth.

Anyhow, that's all I've got for now. I'm going to try and sleep so I can forget about this pain for a few hours. I'll try to finish this later.

Good Health to All!

ScottW

Wednesday, August 14, 2013

13 August 2013

Well let's get to it...

Dialysis Weights:

06 Aug 13
Starting Weight:  107.0 Kg
Ending Weight:  104.1 Kg
Water Removed:  2.90 Kg

08 Aug 13
Starting Weight:  106.5 Kg
Ending Weight:  104.0 Kg
Water Removed:  2.50 Kg

10 Aug 13
Starting Weight:  106.8 Kg
Ending Weight:  104.1 Kg
Water Removed:  2.70 kg

13 Aug 13
Starting Weight:  107.5 Kg
Ending Weight:  104.1 Kg
Water Removed:  3.40 Kg

My top weights are inching higher. Although I don't like it, it is happening nonetheless. This is partly due to my indulging lately in fluids. I have let down my guard and have been drinking more water, more milk, more juices, etc. I suspect the other par is my kidneys just not working well enough to compensate for the added fluids. Ah well; time to clamp down again. (sigh!)  ;o)

Labs were drawn last week, and here are the results:


*Albumin (16 Jul):  4.60 g/dL (+.10 g/dL from 18 Jun)
  (A measure of Protein in the blood)

*Hemoglobin (06 Aug):  11.0 g/dL  (-0.40 g/dL from 23 Jul)
  (A Measure of Anemia)

*Ca Corrected (06 Aug): 9.50 mg/dL (-0.10 mg/dL from 02 Jul)
  (A measure of Heart and Bone health)

*Phosphorous (06 Aug):  4.20 mg/dL (- 0.2 mg/dL from 02 Jul)
  (High Phosphorous affects the health of your Heart and Bones)

*PTH Intact (16 Jul):  116 pg/mL   (+10 pg/mL from 16 Jun)
  (A measure of Vitamin D absorption and bone and tissue health)

*K+ (16 Jul):  4.3 mEq/L (-0.20 mEq/L from 16 Jun)
  (Proper potassium levels keep your nerves and muscles working well)

*spKdt/V Dialysis (08 Aug): 1.56   (+0.14 from 02 Jul)

Aside from the usual culprits--Hemoglobin and PTH--my latest numbers look great! Even the spKdt improved, which means that the filtering has increased its effectiveness.
No complaints from me on these labs!!!

Since my last entry, I have had a rather challenging time of it. My exhaustion is terrible. My post-D naps haven't been less that five hours, and I awaken on my off days feeling more tired than when I went to sleep. I end up feeling like I'm just dragging around all day. My housework isn't getting done, and I again have gotten zero accomplished on my personal projects. Take today, for example...
After arriving home from dialysis, I slept for nearly six and a half hours; having to drag myself out of bed. I then spent the evening letting my body recover from the Tx only to find myself, six hours later (as I type this), as exhausted as I was when I got out of bed.
 I HATE feeling like this! Though this is all to be expected, I still don't like it. I have never been one to be ok with tiredness and non-productivity. Quite the contrary!

Anyhow, enough whining...

The bilateral flank pain seems to have eased; which usually means a cyst or two has popped, giving me some temporary relief. I'll take it!

The headache is going strong. I had one day that it was down for about half the day. I had a fairly good day while that lasted! The headache is now at 45 months and counting...

Let's discuss a few things I haven't talked about much lately.

-My eyesight has been up and down. I am wearing my reading glasses most of the time I am on my computer. The incidences of feeling poorly and worsening eyesight is holding true. Again, this is ONLY with reading a/o near-sight. My far-sightedness is just fine.

-The incidences of diarrhea have decreased significantly. Whereas before the diarrhea was the norm; now it is the exception. I don't know how long this will last, but I'll not complain at all.

-The skin flakiness on my scalp and jaw have decreased as well. I still need to be on guard against it, but at least it is now manageable. Getting off of so many meds has certainly helped this, I'm sure.

-I am going to see my chiropractor tomorrow for another adjustment to aid the neuropathy in my feet. The last Tx helped so much; but the pain has returned, as has the increased numbness. Time to take it down a notch or two...

The nausea I've had lately has held fairly steady. I had a terrible bout of it this morning.
I first awoke from it at about 2a, but managed to get back to sleep. For the next two hours I was restless, but finally awoke at 415a. I took only a very small dose of Promethazine, and sat awake until it was time to get ready for dialysis. Once there, I had not one, but two injections of Zofran to calm the nausea. (Yuck!)

My dreams have been deteriorating lately with increasing lack of control. Again, I never remember my dreams, I just remember that I'm not controlling them. I have been reinforcing the self-messages, but I am having a harder time maintaining the control.
I was actually expecting this at some point because of the disease progression. And, since I have decided on when my kidneys will be coming out, it's only natural that my subconscious will begin acting this out ahead of time. The brain simply has to process as things move along. For me, this is usually how that happens.

Earlier today my Transplant team called me for a yearly follow-up. I'll be going in on the 26th of this month for labs, exams, etc. I'll tell you all about it.

All right, that's enough. I've got other things to do before getting back to bed.

Have an outstanding week, everyone!

Remember my personal motto, "Always Be Outstanding!"


Good Health to All!

ScottW

Sunday, August 4, 2013

04 August 2013

Alright...I'm tired--I've already been putting this off--so let's get to it!

Dialysis Weights:

27 Jul 13
Starting Weight:  106.1 Kg
Ending Weight:  104.1 Kg
Water Removed:  2.00 Kg

30 Jul 13
Starting Weight:  106.9 kg
Ending Weight:  104.2 Kg
Water Removed:  2.70 Kg

01 Aug 13
Starting Weight:  106.2 Kg
Ending Weight:  104.2 Kg
Water Removed:  2.00 kg

03 Aug 13
Starting Weight:  105.9 Kg
Ending Weight:  104.1 Kg
Water Removed:  1.80 Kg

Somewhat consistent numbers. I am still baffled by the fluctuating Pre-D weights that are happening in spite of continued urine output and conscious efforts to reduce fluid intake. I'll just keep trying...

The headache has been severe the past week. I am averaging over 4 T3's per day because of it. On average, it's been holding at about a steady 9.0 no matter what I do to alleviate the intensity. Oh well. It's not like I haven't been down this road before! 
The cycle will end, and I'll get my relief; it's just a matter of when.

The extreme exhaustion I mentioned in my last entry has gone on uninterrupted. (As I was typing, I just realized that in my previous entries, the way I'm writing about my sleep doesn't add up very well. My apologies. Let's try this another way...
On the one night per week that is in no way impacted by dialysis--Sunday night--I am averaging 8-10 hours of sleep, plus, between 1-3 naps that day of 15-45 minutes each.
On the Pre and Post D nights--in other words, from say between 12A Tuesday morning and waking on Wednesday morning (this includes my usual post-D nap)--I am averaging between 14-18 hours of sleep over an approximately thirty three hour period, plus a few brief naps thrown in, too.
So, lots of sleep; and I'm still feeling sleepy and exhausted all the time.
(There...I THINK I explained how I look at my total sleep hours...I think...)  :o)

Anyhow, because of the exhaustion, I only got minimal housework done this entire week, and I got nothing done on my personal projects. I didn't even want to think about them. Absolutely no brain power.  Let's hope I have a better week coming up! After all, I'm way behind on my pictures, my writing and planning for things coming up. That just won't do! Too many things to accomplish.

The nausea I've been experiencing has been inconsistent, as well. Whereas last week I had to use Zofran during every Tx, this week I only had to use it on Tuesday. Even my Promethazine use has dropped this week. No complaints from me, though!

My appetite has been pretty steady. There have been a few days when I just felt lousy and didn't want to eat; but for the most part, my usual meal/snacking routine has held up. One thing that has--so far--only slightly impacted my eating properly is my exhaustion. I am having a terrible time getting up the energy to cook. I usually push through this with only a slight effort; but some days, I just can't think about what to eat let alone actually cooking it. If only processed foods didn't have so much junk in them, cooking would be a lot easier.
And for those of you who might say, "Let your wife cook." My response to that is...You obviously have no idea just how disinterested she is in cooking. Her idea of cooking is to open a can, pour it in a bowl and microwave it. She's always been like that; so I've always done the cooking, which I certainly don't mind. Cooking is something I learned as a kid and I normally enjoy doing, so no big deal. However, as I grow more and more exhausted, my inability to do much cooking will end up having a big impact on my proper food intake. Hopefully, all of this will be over before I get to that point! 

In spite of my exhaustion, one thing I am sure to do on every off day is to bathe and properly groom. I firmly believe that a clean body helps you to feel better. Just because I'm chronically ill doesn't mean I shouldn't take pride in my appearance whenever I can. 
I may be sick, but I don't have to obviously look sick. Do you know what I mean? It goes back to the state of mind that I am constantly battling to maintain; and grooming certainly plays a part in that. It's not that I'm vain--that certainly isn't me--it's just that how you look is an outward projection of how you feel about yourself. In my case, I may be sick, but my disease doesn't define who I am. I won't let it. So, I bathe and groom regularly; and in so doing, I help myself to maintain the proper mindset so that I don't lose myself in all of this. In other words, I'm may be sick, but I'm certainly not sickly.

Alight...Well, I just took a T3 for my headache and my flank pain; so, I'd better wrap this up before I can't keep my eyes open--after all, it's now two in the morning, and past time for me to be asleep.

(And of course, now I can't remember what else I was planning on writing. C'est la Vie.)

Have a great week everyone! I will do my best to do so, too!

Good Health to All!

ScottW