17 January 2015

Well, with as much time that has passed since my last full entry, I think I'll stick with a few facts and stats and leave it at that.

As I mentioned earlier, the dialysis clinic in Phoenix destroyed my great fistula. They were extremely rough inserting the needle, not assuring they were even in the proper tract. When I went in again the following Saturday they had no pulse in the fistula, and could not dialyze anything on either site.

As I alluded to before, the clinic offered no assistance to me in knowing what to do or where to go. They literally told me that they couldn't dialyze me and that I had to "find someplace to get my dialysis." No calls to a nephrologist, no advice about which hospitals to go to; nothing.

Luckily, my brother-in-law in a neurologist and he suggested Good Samaritan Hospital in Phoenix. It was an excellent recommendation. Also fortunate was that I had my KARDEX sheet that I got from my home clinic prior to my trip. It had all my meds listed, treatments, hospitalizations, etc. This saved me so much hassle and redundant explanation. The doctors who saw me looked at that sheet, asked a few questions, and zipped me on my way through the system. It was quite literally a life saver. Within a few hours I had a temporary Central line in my neck, and I did two consecutive rounds of dialysis in the hospital. In all, I was there for about twenty seven hours before being released.

I STRONGLY RECOMMEND ANY DIALYSIS PATIENT WHO IS TRAVELING TO GET A COPY OF THEIR KARDEX PRIOR TO DEPARTURE, AND CARRY IT WITH YOU AT ALL TIMES. IT COULD LITERALLY SAVE YOUR LIFE!

I flew home the next day, then was at my vascular surgeon's office the day after that. He immediately sent me to day surgery to place another central line, this time in my R upper chest, just below the clavicle and subclavian artery.

A week later I was back to get that graft surgery, which, as I stated in a previous post, failed within a week. It is because that failed that I must now have another surgery. Yes, I could just go with the central line until I get my transplant. That is a perfectly viable option for me. However, looking at this long-term, and assuming the transplant will fail down the road, I will need an access for dialysis that does not involve another central line. Because of this, I have opted to go ahead with the graft surgery. It will potentially be extremely painful, and I will have a nasty, long scar on my arm. I am willing to do this in preparation for a future free from another dangerous lumen in my chest, should the need arise.

Dialysis Weights

(I am only including the current month and nothing previous)

02 Jan 16

Starting Weight:  96.2 Kg

Ending Weight:  94.7 Kg

Water Removed:  2.50 Kg

Start BP:  131/92     End BP:  116/70

05 Jan 16

Starting Weight:  97.6 Kg

Ending Weight:  94.7 Kg

Water Removed:  1.90 Kg

Start BP:  164/109     End BP:  109/61

07 Jan 16

Starting Weight:  97.6 Kg

Ending Weight:  93.9 Kg

Water Removed:  3.70 Kg

Start BP:  162/98     End BP:  109/93

09 Jan 16

Starting Weight:  96.3 Kg

Ending Weight:  94.0 kg

Water Removed:  2.30 Kg

Start BP:  148/97     End BP:  107/93

12 Jan 16

Starting Weight:  98.0 Kg

Ending Weight:  94.0 Kg

Water Removed:  4.00 Kg

Start BP:  162/102     End BP:  148/93

14 Jan 16

Starting Weight:  95.9 Kg

Ending Weight:  94.2 Kg

Water Removed:  1.70 Kg

Start BP:  129/89     End BP:  96/68

16 Jan 16

Starting Weight:  97.0 Kg

Ending Weight:  94.1 Kg

Water Removed:  2.90 Kg

Start BP:  137/85     End BP:  119/63

My weights are finally evening out again. After my Thanksgiving trip, it took my weeks to get my weight under control again. I had numerous 4+ Kg removals throughout the Christmas season. I don't know what it is about traveling; but when you go, fully expect a massive weight gain, then weeks of getting it back on target once you get home.

January Labs Results

(Again, because of Phoenix, I am not listing the December labs, and am also comparing the current numbers to my November 2015 labs)

*Albumin (22 Dec): 4.00 g/dL     (No Change from 20 Oct)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (05 Jan): 10.1 G/dL    (+0.20 from 20 Oct)
  (A Measure of Anemia)

*Ca Corrected (05 Jan): 9.50 mg/dL     (-0.30mg/dL from 06 Oct)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (05 Jan):  4.10 mg/dL    (-0.60 mg/dL from 06 Oct)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (22 Dec):  385 pg/mL     (+118.0 pg/mL 20 Oct)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (12 Jan):  5.7 mEq/L    (+0.30 mEq/L from 20 Oct)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (05 Jan):  1.71     (-0.17 from 06 Oct)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher  

I really can't complain about my labs whatsoever. They were a bit wild once I returned from Phoenix, but I have gotten them under control as well, just as I have gotten my wild weight swings back in check. There is likely a direct correlation there, but I am not going to explore it right now.

As I use the lumen (the central line) in my chest, I have had to learn a whole new set of rules to go along with it. If you don't know what a central line is, just look it up on the internet. The biggest rule to follow is to keep it clean and free of contaminants. Why? Because the lumen is a direct line of infection to the heart. THAT is why a central line is so dangerous. As a Kidney patient, with a compromised immune system--and soon to be with no immune system whatsoever due to an impending transplant--any serious infection acquired via the lumen (the actual device placed into your descending aorta) could actually kill you! So KEEP IT CLEAN!

Next, your dialysis tech should always use a mask (you, too!) when they are hooking up the lumen and taking you off of dialysis. This is also to help prevent infectious transfer. Along with this, they should always wear gloves, use alcohol swabs when contacting any part of your central line.

Your lumen is "packed" post-dialysis with either Saline or Heparin. This prevents back-flow into the lumen, and helps keep the ports on the lumen clear of clots or other blockages. This past Thursday I had to have a nurse [pack my lumen with Activase, a Thrombolitic, because my flow was decreasing from 400 to 200, and my dialysis was far less effective as a result. So, the Activase was put into my lumen. When I went back yesterday, my flow was much better at 350. *In my clinic, only a nurse can pack the lumen with Activase; whereas a tech can pack it with Heparin or Saline.

Next, if your lumen flows properly, you should have Yellow Caps on your access sites. These should be changed once per week--Thursdays for me--to prevent infectious buildup on the access sites.

However, since I am having flow issues, I now receive Blue Caps that are changed out every single Tx. This reminds the techs to my lumen must be packed with Heparin after my dialysis session, which helps the flow the following session. It is also to prevent infectious transmission.

When you bath, You MUST keep your central line dry and free of soap or other contaminants! This is ABSOLUTELY VITAL to your well being!! To get around this so I can bathe, my wife washes my hair in the kitchen sink, then we cover the lumen and access sites (and bandage) with a thick plastic sheet, and then tape all around it against my chest. Then, I wash the lower part of my body in the shower, and my wife helps clean my arms and back, being sure to keep the water away as much as possible. I've done this now ten plus times and my lumen and bandaging has so far remained dry.

The only really good part about using a Central Line is that once I'm off the dialysis lines, I am done and can pack up and go home. No waiting around to hold my access sites so I clot properly; I just get to go...which is really nice!

Anyhow, I'm done for now. With my surgery fast approaching, this is likely my last entry for at least three weeks. Please check back occasionally as you never know when I could type up even a brief entry. Wish me luck, send a few good thoughts my way, and please, keep me in your prayers.

Good Health to All!

ScottW

**The upcoming surgery will be either an Artificial Loop Graft, or a Basilic Vein Transposition. Which one is done will depend entirely on my vasculature; which, the surgeon will know once he is in my arm. 

Look them up so you can understand what I am about to go through. Both are on WebMD and other sites, as well.

13 January 2016

My first entry of 2016 will again be brief.

I did NOT have that fourth procedure in late December after all. The evening before it was to happen found my wife feeling sick, and since she's the one taking care of me post-surgery, I decided to postpone the procedure. I am now scheduled to go under the knife on 22 January.

While my wife getting sick was bad timing, the extra time between surgeries has been only beneficial to my healing. My R arm is looking great, and the soreness is nearly gone. Plus, my energy has only just begun to return. I am sleeping less, feeling better more consistently, eating better, and am on far less meds than just a week ago. By the time the next surgery happens, it shouldn't wipe me out as badly as anticipated.

The chest tube has finally grown to be more comfortable; though caring for it is a pain. The poor excuse for a shower I am able to take is barely enough to get me clean, and I have to have my wife wash my hair in the kitchen sink to keep the lumen and insertion point dry and free of contaminants. Oh well. The things we must sometimes do to stay alive...

Anyhow, it's already late, and I must be awake in just five hours for my next round of dialysis. Again, I WILL write this all out...hopefully before the next surgery. But no guarantees!  ;o)

HAPPY NEW YEAR, Everyone!

Good Health to All!

ScottW

23 December 2015

Another brief entry today...

The graft I had placed two weeks ago has failed. The vascular surgeon was concerned this might happen based on what he saw during the surgery to place the graft.

So, next Monday (28 Dec), I will have a fourth procedure this month to place one of two things. 1) An Artificial Loop Graft in my R arm to replace the Central Line that is now in my chest. 2) A Basilic Vein Transposition in my R arm. This would be the first of two surgeries if this option is used.

Of course, I know you are wondering why there are two possible surgeries. That's because the vasculature in my R arm may no longer be able to sustain the Loop Graft. In that case, the surgeon will opt to do the Basilic Vein Transposition. Unfortunately, he just won't know which option is best for me until he gets into my arm and sees which will be the better option.

So, after the surgery, I get to look forward to another two to three weeks of recovery...again.

I promise that I'll get all of this written out; it's just going to have to wait until I heal from this next surgery. (What fun!)

Again, May each of you have a Very Merry Christmas! May your homes be filled with the Love and Joy this Holiday Season so warmly brings.

Good Health to All!

ScottW

News for December 2015

Since my last post, a whole lot has happened. For now, I will give you the short, short version. Once my body heals, I will write what happened in more detail.
While on vacation in Phoenix, the dialysis clinic there messed up my perfect fistula. As a result, they sent me away only with instructions to "find someplace to dialyze."
I ended up at Good Samaritan Hospital. While there I received a temporary Central line in my neck. I did two consecutive rounds of dialysis, had the line removed and came home.

The day after arriving home I had another Central Line placed, this time in my R upper chest. This one is also temporary.
Then this past Monday I was having surgery again (for the third time in just over a week!)
to place a graft that circumvents the blockage in my fistula. So now, I am dialyzing on my regular schedule, but through the Central Line. Once my arm heals, I will lose the line and start doing dialysis through the graft.
I am still obviously healing from everything, so my typing is extremely limited. It could be a few more weeks before I write another entry.
In the meantime, I wish each and every person reading this a VERY MERRY CHRISTMAS! Happy New Year, too!

Good Health to All!

ScottW

P.s  My standing on the transplant list is unaffected! (Yay!!)

06 November 2015--Report on My Cardiac Stress Test

I had my once every 18 months Cardiac Stress Test, as required by the Transplant Committee. The test took place this past Wednesday at the IMC campus just outside of Salt Lake City.
The first step was a pre screening set of scans done on a combo MRI machine and rotating x-ray scanner.  This was followed immediately by hooking me up to a 12-Lead ECG and putting me on a treadmill. Unfortunately for me, my heart rate wouldn't rise enough (to 120-150 bpm), so I was given an IV Vasodilator, which simulates my vessels post-exercise as they flood organs with blood and oxygen.
Unfortunately for me, my body reacted negatively to the sudden and artificially imposed vasodilation, causing extreme nausea and then vomiting. Since I had no food in my stomach--due to eight hours of fasting prior to the test--all I got up was bile...and lots of it!...so the experience was over soon enough. As the drug was fast-acting, after I threw up, the episode was over, and I returned to the x-ray scanner and MRI for comparison shots of my circulatory system and heart.
Once they finished that round of images I was sent to the cardiologist who told me that everything looks great, and that he has zero concerns for my impending transplant. Also, as a precaution only, he wants me to do a lipid test to look at placque buildup in my arteries. He said that the stress test cannot determine placque, which can easily be controlled by a single med, if warranted. So, I am planning on doing this on Monday. It's just a quick blood draw, and will be nothing compared to dialysis needles. Of course, I will let you know the results when I get them.
So, great news on the cardiac aspect of things. That's another obstacle overcome. Now, if I could only get that transplant...

Good Health to All!

ScottW

**Update (18 Nov 15):  I called the lab for my lipid test results, and the following are the results:

ALT: (NR 12-61)  Result--22

Lipid Profile:

     Cholesterol: (NR 158-199) Result--160

     Triglycerides: (NR 58-149) Result--202

     HDL Cholesterol: (NR 40-63) Result--31

     Non-HDL Cholesterol: (NR <130 result--="" u="">129

     VLDL (?): (NR 12-29) Result--40

     LDL: (NR <100 nbsp="" result--="" u="">89

A few of these results are high, but I have no idea what they are in the first place. I'll have to look them up. For the most part, my cardiac labs look great, so no worries there. I haven't heard any follow-up from the Cardiologist, and unless I do, I'll chalk another one up as a win.
    

26 October 2015

I realize that more than a month has gone by since my last entry, and the only good--but true--reason is that I simply haven't had the energy to type up an entry. Unfortunately, writing my blog isn't the only thing that has gone unattended...

Dialysis Weights

12 Sep 15
Starting Weight:  96.7 Kg
Ending Weight:  93.5 Kg
Water Removed:  3.20 Kg
Start BP:  149/102     End BP:  100/62

15 Sep 15
Starting Weight:  96.7 Kg
Ending Weight:  93.6 Kg
Water Removed:  3.10 Kg
Start BP:  184/105     End BP:  99/66

17 Sep 15
Starting Weight:  96.1 Kg
Ending Weight:  93.5 Kg
Water Removed:  2.60 Kg
Start BP:  159/102     End BP:  117/71

19 Sep 15
Starting Weight:  97.0 Kg
Ending Weight:  94.3 Kg
Water Removed:  2.70 Kg
Start BP:  187/115     End BP:  117/76

22 Sep 15
Starting Weight:  98.0 Kg
Ending Weight:  94.0 Kg
Water Removed:  4.00 Kg
Start BP:  195/111     End BP:  101/61

24 Sep 15
Starting Weight:  96.1 Kg
Ending Weight:  93.5 Kg
Water Removed:  2.60 Kg
Start BP:  177/115     End BP:  116/78

26 Sept 15
Starting Weight:  96.5 Kg
Ending Weight:  93.4 Kg
Water Removed:  3.10 Kg
Start BP:  163/102     End BP:  97/64

29 Sep 15
Starting Weight:  97.4 Kg
Ending Weight:  93.5 Kg
Water Removed:  4.10 Kg
Start BP:  173/117     End BP:  104/71

01 Oct 15
Starting Weight: 96.4 Kg 
Ending Weight:  93.5 Kg
Water Removed:  2.90 Kg
Start BP:  176/107     End BP:  104/63

03 Oct 15
Starting Weight:  97.6 Kg
Ending Weight:  93.5 Kg
Water Removed:  4.10 Kg
Start BP:  156/107     End BP:  101/55

06 Oct 15
Starting Weight:  97.6 Kg
Ending Weight:  93.5 Kg
Water Removed:  4.10 Kg
Start BP:  192/118     End BP:  113/76

08 Oct 15
Starting Weight:  96.5 Kg
Ending Weight:  93.3 Kg
Water Removed:  3.20 Kg
Start BP:  152/98     End BP:  119/44

10 Oct 15
Starting Weight:  96.1 Kg
Ending Weight:  93.2 Kg
Water Removed:  2.90 Kg
Start BP:  173/107     End BP:  116/74

13 Oct 15
Starting Weight:  98.1 Kg
Ending Weight:  94.0 Kg
Water Removed:  3.90 Kg
Start BP:  179/113     End BP:  96/71

15 Oct 15
Starting Weight:  96.4 Kg
Ending Weight:  93.4 Kg
Water Removed:  3.00 Kg
Start BP:  145/103     End BP:  107/78

17 Oct 15
Starting Weight:  95.6 Kg
Ending Weight:  93.7 Kg
Water Removed:  1.90 Kg
Start BP:  147/99     End BP:  107/85

20 Oct 15
Starting Weight:  97.3 Kg
Ending Weight:  93.4 Kg
Water Removed:  3.90 Kg
Start BP:  176/120     End BP:  104/59

22 Oct 15
Starting Weight:  97.8 Kg
Ending Weight:  93.5 Kg
Water Removed:  4.30Kg
Start BP:  159/102     End BP:  97/34 (Umm...I don't believe that diastolic!)

24 Oct 15
Starting Weight:  96.3 Kg
Ending Weight:  93.5 Kg
Water Removed:  2.80 Kg
Start BP:  149/90     End BP:  106/73


(Whew! THAT took a while to transpose!)
Anyhooooo, my numbers are looking good. My pre and post weights are within reasonable gains and losses, and my dry weight--93.4 Kg--has been right on, or very close, most of the treatments.  Personally, I think I may have hit the bottom of my possible dry weight.
I have been at this level for four plus months now, and am still having cramping in both feet and legs following every session.


October 2015 Lab Work:

*Albumin (20 Oct): 4.00 g/dL     (-0.20 g/dL from 18 Aug)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (20 Oct): 9.90 G/dL    (-0.10 from 08 Sep)
  (A Measure of Anemia)

*Ca Corrected (06 Oct): 9.80 mg/dL     (-0.40mg/dL from 08 Sep)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (06 Oct):  4.70 mg/dL    (+0.70 mg/dL from 08 Sep)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (20 Oct):  267 pg/mL     (+48.0 pg/mL 18 Aug)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (20 Oct):  5.4 mEq/L    (-0.30 mEq/L from 06 Oct)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (06 Oct):  1.88     (+0.08 from 08 Sep)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher  

My Albumin continues to drop despite my efforts to eat enough protein. I don't doubt that, unless that rebounds, I'll be given another regimen of Liquicell at dialysis. I don't remember if I told you about Liquicell. It's a liquid form of protein that is given to dialysis patients specifically to raise their Albumin numbers. The Liquicell is a cough syrup-like liquid that is loaded with sugar, tastes a bit nasty (hence, the sugar), but delivers a whopping dose of protein for anyone needing it. I've had the regimen once before for about six doses. Some patients hate drinking the stuff, but it's really no big deal. You quickly down about two ounces after every dialysis session. That's it.

At the start of this blog I mentioned that I've been overly tired the past month. When I say overly tired, it's more like excessively tired. For some reason my energy has dropped to almost zero. I am sleeping more--on average about ten+ hours per day. I am also napping more once again, getting two or three hours each day. Plus, my appetite has plummeted, and appetite fatigue increasing. My mental energy is less, and I am unmotivated to get my blog entries done in any sort of a timely manner, along with pretty much anything else. My house chose have suffered, as have my obligations in other areas for those to whom I provide my time and service. I really don't like this development, and push myself whenever I can. My wife tells me to just let my body do what it needs in order to be as strong as possible for the transplant surgery and recovery. Sometimes, I wonder if I should be pushing myself harder, doing more, rather than sleeping and taking things easy.
I'm hoping this exhaustion will pass. We'll see...

Anyhow, I want to get this posted, so I will plan on doing another entry later this week to catch you up on the rest.

Until then, have a great week!

Good Health to All!

ScottW

 

11 September 2015

News on the transplant front that you'll want to know, plus my regular update...

I met with the Transplant Committee this past Wednesday for my yearly review. In short, they are extremely pleased with my progress on all fronts--dialysis, diet, labs, etc. 

However, due to the new UNOS rules, the U of U has added patients to their list from the State of Nevada, which has knocked my standing down significantly. Instead of being in the high single digits, I am now at #30. This is unwelcome news, to be sure. However, my name can still come up if a perfect match is found. So, the latest estimate is now another 4-6 months...at least.

Also, two new requirements have been added to the pre-transplant workup for the Shingles vaccination, and an updated MMR (Measles, Mumps, Rubella), if needed. I don't know if this is for all patients, or only those over a certain age--I didn't ask that.

Seeing that I had Chicken Pox three times when I was young, I am at a very high risk for shingles; a disease which can destroy a transplant. So doing this is a VERY good thing for me. Also, after the shingles inoculation, there is a one month soft hold on my List status due to the possible side effects of the vaccination.The MMR has the same soft hold period, so I will be getting both done at the same time--assuming both are needed--just so I don't double up the soft hold period.

During my appointment with the Committee, I also had a load of blood work done. Part of those results will tell me if I need the MMR. After I get those results I will be getting one or both shots. 

I also have to have a new Cardiac Stress test. This is done every eighteen months while on the transplant list to assure your heart is strong enough for the surgery and recovery. I will let you know how that goes.

So that's my Transplant Committee review news. Some good, some bad. All in all, I am in terrific shape heading into my transplant!

Dialysis Weights:

25 Aug 15

Starting Weight:  97.6 Kg

Ending Weight:  93.4 Kg

Water Removed:  3.20 Kg

Start BP:  194/118      End BP:  134/85

27 Aug 15

Starting Weight:  95.9 Kg

Ending Weight:  93.2 Kg

Water Removed:  2.70 Kg

Start BP:  170/115      End BP:  126/79

29 Aug 15

Starting Weight:  95.9 Kg

Ending Weight:  93.4 Kg

Water Removed:  2.50 Kg

Start BP:  175/113      End BP:  142/87

01 Sep 15

Starting Weight:  97.2 Kg

Ending Weight:  93.3 Kg

Water Removed:  3.90 Kg

Start BP:  189/104      End BP:  103/77

03 Sep 15

Starting Weight:  96.1 Kg

Ending Weight:  93.6 Kg

Water Removed:  2.50 Kg

Start BP:  185/113      End BP:  130/75

05 Sep 15

Starting Weight:  96.4 Kg

Ending Weight:  93.1 Kg

Water Removed:  3.30 Kg

Start BP:  172/106      End BP:  111/71

08 Sep 15

Starting Weight:  97.8 Kg

Ending Weight:  93.9 Kg

Water Removed:  3.90 Kg

Start BP:  184/106      End BP:  120/85

10 Sep 15

Starting Weight:  96.0 Kg

Ending Weight:  93.5 Kg

Water Removed:  2.50 Kg

Start BP:  185/112      End BP:  128/73

Pretty consistent weigh-ins, and I am hitting my dry weight most of the time. There's also a nice drop in my post-D BP readings. So on this front, my dialysis numbers are looking really good.

September 8, 2015 Lab Work:

*Albumin (18 Aug): 4.20 g/dL     (-0.20 g/dL from 21 Jul)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (08 Sep): 10.00 G/dL    (No Change from 18 Aug)
  (A Measure of Anemia)

*Ca Corrected (08 Sep): 10.2 mg/dL     (+0.10mg/dL from 04 Aug)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (08 Sep):  4.00 mg/dL    (-0.20 mg/dL from 04 Aug)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (18 Aug):  219 pg/mL     (+28.5 pg/mL from 21 Jul)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (08 Sep):  5.7 mEq/L    (+0.20 mEq/L from 18 Aug)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (08 Sept):  1.80     (+0.01 from 04 Aug)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher  

Well, the Potassium is doing its usual jumping around. A couple weeks ago it was at 5.4 mEq/L, and now it's in the high range. There isn't too much more I can be doing to stabilize this result. As I've stated before, the K+ will jump around no matter what I do.

All my other numbers are looking great. Even the Albumin, though at the low end of the range, is still in the green.

My headaches have taken a turn for the worse. Lately they have been a combined mixture of TMD related and dialysis headaches. The two factors make for some rather unpleasant days. Thank goodness I have the right meds to knock them down to manageable size!

Food-wise, I am doing about as well as I can. At least I've honed into the fact that only freshly prepared food is appetizing. This helps eliminate a lot of frustration when it comes to finding something to eat. Everything still has to be light--as in, not overly heavy in regards to fat/greasiness--but at least I finally know what to eat without off-putting my appetite.

My dreams remain completely in my control. Just last night I had another dream that I consciously altered so as to avoid anything frightening. Even though I have been doing this for over four decades, it never fails to amaze me that I can do this.

On that note, my sleep is still all over the place. Last week I had a day in which I slept for twelve hours, but then couldn't sleep for over a full day. This was followed by on and off sleep for the next two days. I still haven't had a full sleep (8-9 hours) on any given day (or night) in weeks. Even my post-D naps will range anywhere from four to seven hours of fitful sleep. All in all, I seem to be getting enough sleep to keep me functioning.

On the mental front, I am in a good place. Looking forward to everything upcoming is a challenge--especially after the latest transplant news--but the effort is well worth it. My day to day routine gets to be extremely boring; but I am keeping myself busy with a variety of activities that challenge my brain, or just keep it occupied.

I believe that is all I have for today. So, enjoy your week ahead, and keep smiling, despite your trials!

Good Health to All!

ScottW