First, I was unable to get to my appointment with the Kidney Clinic yesterday because of a scheduling conflict that arose with my wifes' job. So, I have rescheduled it for the 17th (the soonest I could get in), and will continue with the current regimen of Amlodipine.
Before I get into that, let's cover my latest lab work...
26 Nov 19 Labs
*Creat: 2.54
*HCT: 36.8 (NC) IR
*Hemo: 11.4 (-0.4) IR
*Lymph: 6.8 (-4.0) Very Low
*Lymph ABS: 0.4 (-0.4) Extremely Low
*Neut: 76.5 (-4.5) High
*Neut ABS: 4.0 (-2.2) IR
*RBC: 4.13 (-0.02) Very Low
*WBC: 5.2 (-2.5) IR
*BUN: 37 (+4) Very High
*CA: 8.8 (-0.5) [A Touch] Low
*GFR: 27 (-2) Extremely Low
*Gluc: 96
*K+: 4.1 (-0.4) IR
*NA+: 137 (-2) IR
*MG: 2.1 (NC) IR
*Phos: 3.5 (+0.2) IR
NC= No Change IR= In Range
*Urinalysis
Color: Normal
Glucose, UR: Negative
Hgb, UR: Negative
Ketones, UR: Negative
Leuk Esterase: Negative
Nitrite: Negative
pH, Urine: 5.0 (Normal Range is 5.0-8.5)
Prot, UR: Negative
Specific Gravity, Urine: 1.016 (Normal Range is 1.003-1.030)
The Lymphocytes are the glaring issue on my labs. I had expected them to rebound after the drop to 10.8 in October, so seeing a further sharp decline was surprising. In conjunction, the Lymph ABS also dropped by half, which is also a problem. And with my White Count lower, I must again take precautions whenever I am out and about around people. These primarily are a mask, and using hand sanitizer frequently--especially after touching doors, shopping carts, common goods, etc--and by being sure to avoid touching my face or ears until I can sanitize once again.
So, no big changes; just extra caution.
My Calcium was only a touch lower than the minimum looked for by my doctors, dropping just 0.2 below that point. I am not worried by this at all as the number is so close to the desired range.
On the Urinalysis, there is only one difference from the previous four months.
The pH dropped a full point from 6.0 to 5.0. This drop is likely due to my eliminating the Sodium Bicarb from my daily intake (via meds), and my body is probably still adjusting to no longer having that large, constant supply in my blood. Next month should be a better indicator of this lab value.
Next, I am fully off the Isosorbide and Sodium Bicrab tablets, which I stopped the morning after the med switch. My getting started on the Amlodipine has gone a bit worse than I expected.
My blood pressures have all been elevated, both morning and evening. As a result, I have had to take Clonidine both A.M. and P.M, and I am still getting systolic readings in the 130's (morning) and 140's (evening).
The swelling in my feet that I was warned about is definitely more than moderate. Sleeping helps the edema to reduce, but as soon as I am up and moving, it just comes right back. There is no additional edema in my arms or hands; only in my feet.
Plus, my feet become a bit painful at night from what I am guessing to be further nerve irritation from the fluid shifts caused by the edema. My feet are not intolerable in either edema or pain...just uncomfortable; so much so that even if I could stand to have shoes on, my feet would not fit right now.
Other evident side effects I am seeing are daily diarrhea or loose watery stools. and restless and poor sleep (more than usual, at least) which has caused a general malaise during the day. I can often fight through the tiredness, but it is always there; even after taking two and three hour naps.
So, sticking with the Amlodipine may not be the best thing, when considering the extent of these side effects. I will discuss the side effects I am experiencing at my upcoming Kidney Clinic visit.
Also, the drawdown of the Protonix has gone well. I have just one more single dose to take in a few days, and then that med will be eliminated. I stuck with the drawdown schedule I noted, and without the Isosorbide present, I have had zero nausea, acid reflux or gastric burps! (YAY!!)
The cold I was getting has abated almost entirely. Thanks to the rejection med-friendly combination of Mucinex and Delsym, I was able to keep the cold from exploding. It has taken almost two weeks to tamp it down, but with my immune system lower, I am not surprised that has taken so long to overcome.
Despite the peripheral edema [in my feet], my weight has remained consistent. I am currently at 124.5 Kg's as of this morning; where it has stayed within 3/10's on either side for the past week plus. So, despite the edema, my kidney continues to process all fluids properly; it just so happens that fluid is collecting in my feet [because of the Amlodipine] instead of other places throughout my body.
My appetite is good, my dreams are completely controlled, and without the Isosorbide and Protonix, my headaches are fewer! The constant low-grade headache is completely gone...finally!
The TMD is still ever present, but I can now concentrate on only the TMD, and address that from day to day.
If fact, I have had several days--despite the cold--that I took only Excedrin for a mild headache...and it took the headache away! This development is incredibly encouraging!
It tells me that my TMD is a bit better than I had thought, and that I am closer to getting it under control than since the headaches started back up a few months after the kidney disease really kicked in back in early 2010.
I am hoping that within a few months, I can get the TMD to settle down so much that my T3 use is down to few, if any. Knowing how severe my TMD is, that timeline may not be possible; but I'll try anyhow. I look forward to having zero uncontrollable headaches once again, and now, I am closer than ever to achieving that!
With that piece of good news, I will close this entry.
Upcoming appointments are Nephrology (17 Dec) and Kidney Clinic (also on 17 Dec).
I may or may not get an entry written before that. If not, you'll have a full report on both appointments within a couple of days afterward.
Good Health to All!
ScottW
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