Post-Transplant Update: 17 November 2018

The results from last weekends' Lasix test were disappointing; to say the least.

Over the four days I had, I lost a total of 1.30 Kg--or, about 2.8 pounds. The weight loss was NOT consistent, however. From day to day my weight would just yoyo. Luckily, the last day ended on a drop to give me the final total loss.
I spoke with my Clinic doctor on Monday, and with the abbreviated weight loss, the doctor wants to up the Lasix from 40 mg 1x/day to 40 mg 2x/day to see if this makes any difference. I have been on this schedule since Wednesday, and have dropped only about 3/10's of a Kg in overall water loss. So far, I have had no cramping or any signs of dehydration. As per instructions, I am to call the doctor once I hit a sustained total loss of 1.6 Kg.

My labs this week were nearly all improved. Let's look at those...

13 Nov 18 Labs

*Creat:   2.70 (+0.25) An unexpected rise

*HCT:   33.7 (+0.8) Low

*Hemo:   10.4 (+0.3) IR

*Lymph:   9.0 (+6.2) Very Low

*Lymph ABS:   0.5 (+0.3) Very Low

*Neut:   77.3 (-3.8) High

*Neut ABS:   4.0 (-1.2) IR

*RBC:   3.66 (+0.08) Low

*WBC:   5.2 (-1.3) IR

*BUN:   45 (+3) Extremely High

*CA:   9.9 (-0.1) IR

*GFR:   25 (-4) Extremely Low

*Gluc:   106

*K+:   4.2 (-0.3) IR

*NA+:   139 (-2) IR

*Prot:   6.9 (+0.1) IR

*MG:   2.4 (+0.1) IR

*Phos:   3.9 (+0.4) IR

*BK:   Not Detected

*CMV:   Not Checked

      NC= No Change     IR= In Range

The good news on the labs is that the Hemoglobin, Hematocrit and Red Blood Cells all showed improvement over the past two weeks, and with no additional help from an Aranesp injection! Plus, nine of the labs  ended up in the proper ranges; which is excellent!
On the not-so-good side of things, the Creatinine jumped unexpectedly. This could be due to two things either individually, or in conjunction:  my sustained weight gain and the muscle building I am achieving in my legs as the result of my daily walks. 
Though the doctors are not yet sure why the Creatinine is higher, which is one reason I am trying to lose more water weight.
Plus, I am told by the Clinic doctors that building muscle will raise the natural Creatinine level in your body. So because of that fact, as I grow stronger and start more and more exercises, it will be interesting to see just where my Creatinine ends up.

Anyhow, along with the jump in Creatinine, both the BUN and GFR took jumps in the wrong directions. While I know that these three are connected, I do NOT understand the pathophysiology of said connection, nor any associated issues that occur because of the movements. I really cannot even guess the outcomes of those connections.

Also on the labs, the Lymphocytes did another big jump this week. I am hoping that, with the amount of time that has passed since the rejection, the stabilization I have discussed previously will now begin. 

The TMD headaches this week have been terrible. My T3 usage is up to 4/day (+ Tylenol). That increase is about 1.3/day over earlier this month. The previous lull in the intensity and frequency [of the headaches] is definitely gone. My jaw is popping BIG TIME! Even using my NTI devices at night has been zero help. So, I go on...

The walking has been going well. I am doing that same loop a bit faster, and with less help from the cane. I will be timing myself this coming week and working to lower that time a little every day. With time, I will add on more distance as I slowly increase my ability to walk, strengthen my legs and increase my stamina. My current lack of muscles mass and stamina took nine years to devolve to. Getting back all of those muscles and stamina will also take a long time, as previously discussed. But again, at least I have started on that lengthy path.

My appetite is staying within my physical activity. My fluid intake remains between 2.5-3.0 L per day despite the Lasix. I will adjust this as needed on the diuretic therapy.

My brain is waking up more, and I have finally begun running errands by myself. I'm talking  about grocery shopping, getting household supplies, and picking up my meds all by my lonesome! (Believe me, if you understood what all of that means to my wife, you'd have a huge appreciation for what she did for me the last nine years! So this is BIG!)
Doing all those errands wears me out, but at least I am getting them done with no assistance.
Plus, I am remembering details, questions and even short-term memory with greater accuracy than since I was placed on dialysis. In effect, I am finally getting my brain back! This too will be a long road to fully realize a healthy brain, but I am well on my way!

I think that that is all I have for you today. 

With Thanksgiving celebrations next week, I may not get a new entry written until the following week. If I don't write, I hope that you all have a safe, enjoyable Thanksgiving holiday!

Good Health to All!

ScottW