Post-Transplant Update: 01 May 2020

The week-long increased dosing of Torsemide is done, labs have been drawn, and the next step is in motion.

Over the course of the previous week, the high dosage of Torsemide went uneventfully. There were few extra side effects, and despite the diuretic, I actually ended up gaining weight. When I began this regimen, my weight was at 121.5 Kg. At first, my weight went down, then gradually increased to 122.7 Kg. This was unexpected, but also not a surprise, as a failing kidney will not always follow the expected outcome.

Also during the increased Torsemide, my morning and evening BP's decreased to somewhat acceptable levels, being in the high 120's to high 130's (systolic) in the mornings, and the high 130's to mid 150's (systolic) in the evenings. A little success here is better than none at all.

Now the labs...

30 April 20 Labs:

*Creat:   3.13 

*HCT:   36.0 (-1.3) Low

*Hemo:   11.3 (-0.4) IR

*Lymph:   17.9 (+4.0) Just Low

*Lymph ABS:   1.1 (-0.3) High

*Neut:   74.2 (-5.1) Just High

*Neut ABS:   4.4 (-3.8) IR

*RBC:   3.98 (-0.19) Extremely Low

*WBC:   5.9 (-4.4) IR

*BUN:   48 (-11) Extremely High

*CA:   8.9 (-0.5) Low

*GFR:   21 (-4) Extremely Low

*Gluc:   106

*K+:   3.4 (-0.6) Low

*NA+:   139 (+1) IR

*MG:   2.3 (+0.2) IR

*Phos:   3.9 (-0.1) IR
          NC= No Change     IR= In Range

The Creatinine was already going to artificially elevated because of the increased Torsemide. However, 3.13 seems to be a bit too high considering that my weight actually increased over the past week.
The drop in the Red Blood Cells is a surprise. I had expected for it to at least hold steady; but no such luck. This is another good indicator that the kidney is struggling.
I was happy to see the BUN drop; but it was far too little. 
And the GFR has nearly declined to the level that renal patients are placed on a transplant list (20). This number is of great concern.
On the Potassium, I expected this as any diuretic pulls potassium from the body. 

My Urinalysis had some variances as well...

Appearance:   Normal
Color:   Normal
Glucose:   Negative
Ketones: Negative
pH:   7.0 (Normal Range 5.0-8.5)
Protein:   Negative
Specific Gravity:   1.008 (Normal Range 1.003-1.030) *Historically, this value has been hovering at approx. 1.015

While the majority of the U/A is normal, the pH is abnormally high, and the Specific Gravity has decreased. Though I do not understand the correlation in whole, the general idea is that my kidney is showing signs of struggling to filter properly.

Following labs, I waited for a call from the Transplant Clinic, which arrived late on Thursday evening. The doctors agreed that the next step is to biopsy the kidney, and see what we can learn from that. 
The biopsy should be happening in the coming week.
In other news, this past week saw my headaches increase significantly. Some were TMD-involved, and others were not. AS there is a strong likelihood that this uptick of headache frequency and intensity is mere coincidental [with the kidney problems], I will observe the headache pattern in the coming weeks and note any changes to quality, intensity and how strongly the TMD is contributing. 

Lastly--and again, this may only be coincidental--I have felt abnormally tired again. I am concerned that this could be psychosomatic, so I am actively keeping my brain in a good place and active as much as possible.

When I know the date of the biopsy I will amend this entry, and note that at the bottom.

Have a great weekend!
Stay safe, and as the nation starts to return to normal, continue your social distancing protocols as much as you can. Remember, there is a strong probability of a second wave of the Wuhan/Covid/Chinese/Corona Virus which has the potential to be worse than this initial outbreak. 

Good Health to All!

ScottW

*I found out late yesterday that the biopsy is scheduled for tomorrow (Thursday, 07 May).