Wednesday, November 8, 2017

Post-Transplant Update: 08 November 2017

Wow! An entire month has zoomed by and my upcoming surgery is now imminent.

My at-home work has kept me busy and uses all of my energy, which is why I haven't gotten anything done on my blog. Now, with the surgery nearly here, it will be a few more weeks--at least--before I am able to write another. So, let's get started...

Overall I have been feeling better. The kidney is working pretty well, though my urine output is up and down, leading to some unfortunate weight gain. As of this morning, I am at 115.5 Kg, up from the approximate 108 Kg a month ago. I spoke with my Transplant Team Nephrologist about the weight gain and he urged me to take a cautious approach until after the surgery, and my bladder is no longer interfering with the whole plumbing system. Once it is properly in place, my urine production is expected to be consistent and output to increase. I'll let you know.

I am still having days, like yesterday, when urine production is great and I excrete more than I take in. I drank just over three liters yesterday, and outputted four liters. I like that. Conversely, there are frequent days that I take in 3-4 liters of fluid, but output only 2-3 liters, which adds to my weight. There is no real average for output, and I am trying to alter my input on a daily basis to try and avoid that extra fluid retention. Based on my current weight, those efforts have not been very successful.

My lab results have finally settled into a somewhat normal pattern. Because of this, I have had zero changes to my meds in over a month. The following are my last few lab results a week apart...

                 23 Oct           30 Oct                 06 Nov

Tacrolimus:  8.4               8.8                     9.4

Creatinine:  1.74              1.89                    1.71

WBC's:         6.4                7.3                      6.1                      

RBC's:          4.08              4.1                      4.09
                
Hematocrit: 37.0              37.0                     36.6

Lymphocytes: 11.3            13.0                     12.3

Lymph ABS:       0.7             1.0                      0.8

Neutrophils:   67.0              71.1                    65.1    

Neut ABS:        4.3                5.2                      4.0

GFR:               43                 39                       44

BUN:              30                  35                       38

Glucose:       101                 105                      108

Phosphorous:  3.6                  3.3                      3.5

Hemoglobin:   11.9               12.1                    12.2

Potassium:       4.6                 4.6                     4.8

Aside from the inexplicably high Glucose readings (100 should be the top) when I      haven't eaten before labs are drawn, everything is looking really pretty good! As we move forward towards surgery healing and lowered anti-rejection meds, these numbers will move up or down, depending on the individual lab values.

My headaches have been increasing and decreasing in intensity from day to day. I have actually begun having some days that Tylenol only is talking care of the headaches. It's a welcome bit of progress.

My feet continue to improve from the years of dialysis neuropathy. I have even begun to notice things that my feet touch, which hasn't happened in probably four plus years. I have been having frequent pin prick sensations throughout both feet that tell me the nerves are beginning to heal. The constant burning is still there, but has decreased in its intensity. I only need to soak my feet every week or so, and in water that is much warmer than the frigid ice baths I used to place my feet in.  Sleeping with my feet under the covers is still an impossibility, but with all the nerve healing going on, I'm hoping that won't too much longer.

My heart seems to be doing great. No more sudden shortness of breath, no racing of the heart when I lay down...only time will heal my heart as much as possible, but I believe that it is well on its way.

Now, on to the surgery.

I have a pre-appointment with the surgeon--one of the Transplant Committee--on Monday (13 Nov 17) at 1100a. We have already discussed much of what will happen, so this appointment will likely be more of a review than anything.

The next day (14 Nov 17) I go in for the Triple Hernia Repair. The surgery should take 3-4 hours. On the top two hernias, the repair mesh will be placed underneath the muscles, while the hernia over the bladder will have mesh placement on top of the muscle. This last one is so that the mesh does not irritate the bladder, making me more comfortable, and lessening any chance of an inflamed or infected bladder.

The hospital stay should be between 3-4 days, then home after that. I anticipate home recovery to take around 3-4 weeks. I'm hoping that after two weeks that I can do at least a little bit of work each day.

Total recovery time should be between 6-8 weeks.

So, that's all the latest.

I will update you when I am able to sit up for longer than a few minutes; which will probably end up being three weeks, or so.

Please continue to keep me in your thoughts and prayers so that the surgery goes extremely well, as does the recovery.

Hopefully...this is THE last major obstacle to get past in order to heal completely.

Until I write again...Happy Thanksgiving to all my American readers!

Good Health to All!

ScottW



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