12 September 2016

I know it has been longer than I like between posts, but I wanted to get two appointments finished before I wrote. And a third is happening this afternoon; but with dialysis tomorrow, I really didn't want to wait at least two more days before posting this update. I'll just add on a report about my Transplant Committee Yearly Review (today's appointment) to the end of this one, so if you read this before I add on, please check back to read up on the latest with Transplant!
So, let's get started...

Dialysis Weights:

23 Aug 16

Starting Weight:  102.5 Kg

Ending Weight:  100.2 Kg

Water Removed:  2.30 Kg

Start BP:  185/89     End BP:  123/98

25 Aug 16

Starting Weight:  102.3 Kg

Ending Weight:  100.3 Kg

Water Removed:  2.00 Kg

Start BP:  144/91     End BP:  116/65

27 Aug 16

Starting Weight:  102.2 Kg

Ending Weight:  100.6 Kg

Water Removed:  1.60 Kg

Start BP:  127/84     End BP:  126/73

30 Aug 16

Starting Weight:  103.7 Kg

Ending Weight:  100.3 Kg

Water Removed:  3.40 Kg

Start BP:  164/104     End BP:  114/76

01 Sep 16

Starting Weight:  101.7 Kg

Ending Weight:  100.3 Kg

Water Removed:  1.40 Kg

Start BP:  129/83     End BP:  114/76

03 Sep 16

Starting Weight:  103.1 Kg

Ending Weight:  100.2 Kg

Water Removed:  2.90 Kg

Start BP:  155/101     End BP:  113/72

06 Sep 16

Starting Weight:  103.5 Kg

Ending Weight:  100.2 Kg

Water Removed:  3.30 Kg

Start BP:  164/101     End BP:  102/61

08 Sep 16

Starting Weight:  102.6 Kg

Ending Weight:  100.4 Kg

Water Removed:  2.20 Kg

Start BP:  153/115     End BP:  100/80

10 Sep 16

Starting Weight:  102.9 Kg

Ending Weight:  100.3 Kg

Water Removed:  2.60 Kg

Start BP:  178/102     End BP:  100/70

As you see, my ending BP's are starting to have a problem with being too low. Remember, my Vascular Surgeon needs the end BP to be greater than 110 systolic. This helps the artificial graft to stay open.

*A slightly hypertensive patient has a greater ability of keeping the flow going through an artificial graft.

So, as my ending BP goes down, I get to increase my dry weight which will now go to 100.5 Kg. This probably isn't the last time I will increase my dry weight to accommodate a lowering BP.

September 2016 Labs

*Albumin (16 Aug): 4.10 g/dL     (+0.10 g/dL from 19 Jul)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (09 Sep): 10.50 G/dL    (-0.30 g/dL from 02 Aug)
  (A Measure of Anemia)

*Ca Corrected (09 Sep): 10.0 mg/dL     (+0.20mg/dL from 02 Aug)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (09 Sep):  5.20 mg/dL    (+0.40 mg/dL from 02 Aug)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (16 Aug):  360 pg/mL     (+97 pg/mL 19 Jul)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (06 Sep):  5.4 mEq/L    (+0.20 mEq/L from 02 Aug)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (06 Sep):  1.71     (-0.07 from 02 Aug)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher  

GREAT September labs! All greens is the best way to go! All my efforts once again pay off with terrific lab results! See....I told you it wasn't that difficult to accomplish!  :o)

Now. my news...

I had my yearly Dental Clearance last Wednesday, and all my efforts in that area are paying off, as well. After another year, my teeth are in great shape with no cavities and zero infections! I also had my teeth cleaned the same day. I should be doing this every six months, but with everything that has happened since last Thanksgiving, I never got to it. At least I had a great reason, and it wasn't because I was just blowing the cleaning off.

Anyhow, I have the Dental Clearance form in-hand and will be taking to my Transplant Coordinator this afternoon.

Also, last Friday I had my latest Eye Exam. Not that I had to do it for transplant again, but just because it has been four years since my last exam (and the initial Transplant Clearance). So, after these four years, my eyesight is still 20/20, with no astigmatism or cataracts. The only thing I need to do for my eyes is update the Rx on my reading glasses for the Ocular Divergence that I have had for decades.

Remember, the Ocular Divergence has nothing at all to do with sight. It is merely the muscles around the eyes not being strong enough to keep the eyes centered. The glasses are slightly prismatic on the sides in order to keep the muscles in the proper position for reading.

*This condition must be diagnosed by an Opthamologist, as an Optometrist won't recognize this muscular issue.

OK, on with everything else...

As far as how I'm feeling since my last post, all I can say is, 'More of the same.' More exhaustion; more sleepiness; more poor appetite, etc. Again, this isn't anything I am or am not doing. This has everything to do with no kidneys, and only so/so dialysis treatments. So/so because of continuing to use the Central Line as the flow is not as good as using the artificial graft.

During Tx (treatment), on the Central Line, the maximum flow I can do is 400. On the graft, it is 450. As I explained before, the higher flow with the graft is able, over the course of a weeks' Tx's, to deliver the equivalent of one additional dialysis session in the same amount of time.

This additional flow means my blood is cleaner by far every week that passes on the graft.

Luckily for me, I began using the graft again 5 sessions ago.

So far, there has been no more leakage. My Vascular Surgeon, whom I saw on 31 August, said (after viewing the latest ultrasound mapping) that the graft has integrated with my arm quite nicely, the flow is fantastic at over 1700+ (the goal is at least 1000) and it seems to be working properly.

As for the leakage, he could not explain it. However, he instructed me to have the venous side venipunctures--the suspected side for the leakage--done more in the middle of the venous side of the graft rather than near the top of the loop distal to the elbow. And,

I have used the instructed venipuncture area for five treatments now, and there is no leakage whatsoever! I must have about one months' worth of successful dialysis sessions before the Vascular Surgeon will even consider removing the Central Line. I'm OK with that! So many problems with my R arm access have led me to being very cautious with anything regarding it. When, or if, it actually gets excised, I will let you know right away!

That's all I have for now. As I stated earlier, I have my Yearly Transplant Committee Review this afternoon. This years' review is the briefer one, which means no cardiac or other testing, and the review should only take about an hour. Also, I will add on the report about my review at the end of this blog.

Until then...

Good Health to All!

ScottW

14 Sept 2016

Some great news!

During my yearly transplant committee review on Monday afternoon, all the various committee members (Financial, Dietician, Nephrology, Social and Coordinator) were extremely pleased with how I am doing, and especially my 100% compliance on every area they look at. I have even offered my assistance to the committee as a guest speaker for the new patient orientations.

As with my initial visit, I would offer tips for meeting compliance, encourage the patients with helpful thoughts, answer questions, etc. I am offering this because the person I had to listen to was probably the worst possible patient you could want as he droned on endlessly about his sad life story and what got him to needing a transplant. There was no insight, no help; I just left with nothing gained and more questions.

So, I figure that after my experience and getting things right, that I could pass on the knowledge of what was helpful, how to move forward, how to think, etc.

Now, the news...

In meeting with me, my coordinator informed me that as of early June (of this year), I was at #11 for my blood type. That's a full 24 spots higher than April, which means I am likely in the mid single digits right now! If all goes as anticipated, I should have my transplant by the end of the year, or shortly thereafter! Woo-Hoo!  :o)

There are, of course, no guarantees on that timeline, but the committee does not foresee any further bumps downward on the list as the shakeout from the UNOS rules changes (in Dec. 2014) has finished, and wait times should now be more accurate.

About the only thing holding up any delay would be a lack of donor or cadaveric organs, and with the Holidays approaching, it is a grim reality that a large number of cadaveric organ donations will become available over the next three months.

While sad for those who lose a loved one, the gift of life gives happiness to many others who benefit the tragedy.

So, in any thoughts or prayers for me, please remember those whose life is lost so that I might regain mine. Also remember the families who are impacted and seek for their comfort, as well.

A Quick Update

I have some good news...

...As of Friday afternoon, I am officially BACK on the Active Transplant List. I had called my coordinator on Thursday afternoon, and my return to Active status was confirmed about 24 hours later.
So...more carrying my phone 24/7.

I have my eye exam and dental clearance both coming up next week, followed by my yearly transplant committee review the week after.

Lots coming up...

21 August 2016

More than two weeks have gone by since my last entry, so lets get going...

Dialysis Weights:

06 Aug 16

Starting Weight:  101.6 Kg

Ending Weight:  66.7 Kg

Water Removed:  1.90 Kg

Start BP:  155/87     End BP:  126/108

09 Aug 16

Starting Weight:  102.1 Kg

Ending Weight:  100.0 Kg

Water Removed:  2.10 Kg

Start BP:  159/101     End BP:  161/109

11 Aug 16

Starting Weight:  102.3 Kg

Ending Weight:  100.0 Kg

Water Removed:  2.30 Kg

Start BP:  138/87     End BP:  156/104

13 Aug 16

Starting Weight:  102.9 Kg

Ending Weight:  100.2 Kg

Water Removed:  2.70 Kg

Start BP:  141/81     End BP:  124/103

16 Aug 16

Starting Weight:  102.9 Kg

Ending Weight:  100.3 Kg

Water Removed:  2.60 Kg

Start BP:  153/91     End BP:  100/71

18 Aug 16

Starting Weight:  102.1 Kg

Ending Weight:  100.1 Kg

Water Removed:  2.00 Kg

Start BP:  146/89     End BP:  114/83

20 Aug 16

Starting Weight:  103.1 Kg

Ending Weight:  99.8 Kg

Water Removed:  3.30 Kg

Start BP:  155/97     End BP:  113/86

While my weights have all been in line, the BP readings have been all over the place. The entry readings are OK, but the exit readings range from great to bad; especially looking at the Diastolic reading (the second of the two). Some are great, while others are not good at all. I don't really know what I can do to rectify this, aside from everything I am doing right now.

Just another ten days until I call my Transplant Coordinator and place myself back on the Active List. It's been odd not having to be on guard 24/7 with my phone this month. Relaxing, but odd. Soon enough I will have my phone with me 24/7 once again. Hopefully, I get my call soon. I am no longer hoping for any time frame. I've been disappointed too many times since the new UNOS rules went into effect. From now on my attitude about receiving my call is, 'I'll believe it when I get it.' This leads to much less anticipation and disappointment.

In the meantime, I will continue keeping my mind in a good place, challenging myself mentally with games of logic, strategy and timing (this keeps my brain sharp), and do everything I must in order to be as healthy as possible going into the transplant. Doing both will help to ensure as successful a post-transplant outcome as can be expected--aside from organ rejection from extraneous reasons completely out of my control.

I continue to sleep more than usual. Over the past week or more, my average sleep around each dialysis treatment (Tx) has ranged from 18-22 hours. That is up significantly from 13-17 hours. It is what it is, and I work hard to prevent frustration from creeping up on me due to the sheer number of hours I am now sleeping. After all, excessive sleep is why I received my disability judgement, so why be upset that I am doing a great job at earning my monthly payment?

Along with the sleeping increase, I am also napping more each day; anywhere from 15-45 minutes several times each day. Like I said, it is what it is. No frustrations.

My appetite continues to be poor. Even my once per day decent meal has become 'once per day so-so' meal. Finding palpable foods is becoming more difficult as even the slightest off-putting factor is increasingly making foods unappetizing. Oh, for the transplant and pretty much every food looking great once again! I'll get there...

I don't remember if I mentioned, but due to the latest leakage in my arm during dialysis [from the graft], during an appointment in which I was going to have the chest tube removed [at the end of the month], I am now going to have the graft mapped to assure it is working properly, and discuss with my vascular surgeon how to prevent leaks from the graft, and whether or not eliminating heparin from the dialysis Tx will lead to the graft clotting off due to my high blood clotting factor. I will definitely let you know on that. In the meantime, I will continue to use the chest catheter exclusively...again...

That's about all I have for today. I will wait until that appointment with my vascular surgeon until I make my next entry. That will be on the 31st of the month, so be looking for a new entry after that.

Until then...

Good Health to All!

ScottW

05 August 2016

My latest labs came back already, so let's get into them...

August 2016 Labs:

*Albumin (19 Jul): 4.00 g/dL     (-0.20 g/dL from 21 Jun)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (02 Aug): 10.80 G/dL    (-0.40 g/dL from 05 Jul)
  (A Measure of Anemia)

*Ca Corrected (02 Aug): 9.80 mg/dL     (-0.50mg/dL from 05 Jul)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (02 Aug):  4.80 mg/dL    (-1.00 mg/dL from 05 Jul)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (19 Jul):  263 pg/mL     (+42 pg/mL 21 Jun)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (02 Aug):  5.2 mEq/L    (+0.60 mEq/L from 05 Jul)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (02 Aug):  1.64     (-0.04 from 05 Jul)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher  

Albumin is the only number with a Red. That means I have been working on, and doing, everything I should be. Diet, fluids, etc.

Once again, following the guidance and recommendations of your physicians, nurses, techs, etc is NOT difficult to do! You simply have to choose to follow their instructions. Do that and you will be healthier, happier and everything will not seem like such a terrible burden. That's never to say that dialysis won't suck...it always will!...but you will be able to hold off complications that would otherwise pop up simply because you refuse to properly take care of yourself. Plus, your mind will be in a much better place, as well!

Remember also, that your Potassium (K+) numbers will go up and down, no matter how compliant you are to the renal diet. All you do is control the intake of K+ rich foods, and avoid becoming frustrated when the labs come back higher than the established range. When that happens--and it will!--just assure that you are avoiding tomatoes, potatoes, certain juices, etc. Having these once in a while is OK...but when you need to get your labs back in line, you already know what to do!

Dialysis Weights:

*For some reason I still don't understand, there is a two week gap in where I record my weights each dialysis session. So, don't be thrown by the gap...

12 Jul 16

Starting Weight: 104.7 Kg 

Ending Weight:  101.3 Kg

Water Removed:  3.40 Kg

Start BP:   210/94  End BP:  120/82

14 Jul 16

Starting Weight:  103.5 Kg

Ending Weight:  100.2 Kg

Water Removed:  3.20 Kg

Start BP:   187/112  End BP:  113/85

28 Jul 16

Starting Weight:  102.2 Kg

Ending Weight:  99.7 Kg

Water Removed:  2.50 Kg

Start BP:   176/94  End BP:  99/55

30 Jul 16

Starting Weight:  102.1 Kg

Ending Weight:  99.7 Kg

Water Removed:  2.40 Kg

Start BP:   159/99  End BP:  101/71

02 Aug 16

Starting Weight:  103.9 Kg

Ending Weight:  100.7 kg

Water Removed:  3.20 Kg

Start BP:   176/106  End BP:  123/61

04 Aug 16

Starting Weight:  102.7 Kg

Ending Weight:  99.9 Kg

Water Removed:  2.80 kg

Start BP:   159/96  End BP:  105/68

And that brings you up to speed. My weights have been good, and when a Tuesday weight is high, I take until Saturday to get it back to where it should be. This is on purpose so that I avoid excessive cramping, and a possible drop in BP that would leave my artificial graft closed and unusable. As it is, I may push my dry weight up half a kilogram because the longer I am at the 99.5 Kg weight, the more the ending BP is lower than I want (110+ systolic minimum).

As far as my sleep goes, I am getting LOTS! Yesterday, I had 5 hours pre-dialysis, slept one hour during treatment, went home and slept 9 hours, then fell asleep again during the night for 6 more; bringing the sleep to 21 total hours! That's a new record for me. Without my kidneys, it seems that the longer I go, the more sleep I'm getting. I have no idea if anyone else experiences this or not; I'm just talking about what I am going through.

And that is all I have for today. I am trying to be cognizant of the passage of time, and have been doing a good job with my recent posts. Let's hope this continues

Have a fantastic week, everyone!

Good Health to All!

ScottW

**Oh, By The Way: I placed myself on Voluntary Hold on the Transplant List for the month of August. I did this because August is one of three times every year that my wife is horridly busy at her work, and there is no one that could just step in and do her job in the event I get my transplant call. So, I did what had to be done so that she avoids that happening.
YES, I will still accumulate time on the list; I just won't be receiving a call at any time during August.
On September 1st I will call my coordinator and reinstate myself to the Active List.  sw

31 July 2016

Tired, tired, tired.

That pretty much sums up the past week.

My Tuesday pre and post dialysis sleep totaled twenty hours (!). On Thursday, it came up to seventeen. Yesterday (Saturday), another sixteen total hours of sleep. And between any times that I am asleep, I am feeling exhausted, sleepy, etc.

I know that a low Albumin count can contribute to excessive tiredness, but my Albumin is, although on the low end of the scale, is just fine. This may have more to do with my poor appetite lately than anything else.

The good news in this is that I am beginning to eat a bit more. While I am still only getting one good meal a day, I have actually been finishing my post-D lunches both Thursday and Saturday, and I am snacking more, as well. Hopefully, this will turn into a growing trend, because I definitely need to be eating more.

On an aside, I have been copying all of my blog posts and have been reading everything I've been going through the past nearly seven years--I can't believe it's been that long! Anyhow, after reading one particular years' worth of posts, I thought I'd mention/update a few things I haven't talked about in some time.

1) Yes, I am still using a cane anytime I am outside of the house. I continue to have issues with vertigo (minor), and still lose my balance at random times. Plus, whenever I grow tired, the cane keeps me on my feet. It has been an invaluable tool for me. When I'm again strong enough, not using the cane will be weird.

2) My eyes continue to fluctuate between good and poor vision. When it is poor, reading is difficult due to blurriness. At those times, my glasses really come in handy. Thank goodness I have those to help. I mentioned a few posts ago that I need to see the Ophthalmologist, which will be coming up.

3) Since abandoning the Minoxidil, it took about two plus years for the whole out of control hair growth to calm down. Not needing the extra hair really set my body on its ear! At least now I don't have hair growing all over the tops of my feet...or at random places in my ears...or on the knuckles of my hands...etc. And there are no more two or three inch hairs growing on my legs, or arms. (Thank Goodness!)  :o)

4) One of the stranger side effects from previous meds I am no longer having was random areas on my head that would see the skin dry out and flake off with just a slight rub, along with seeming uncontrolled dandruff. This would happen on my chin, my jaw line, my ears and sometimes behind the ears. The change away from this side effect is quite welcomed, and never missed.

.......

I had something happen at my dialysis clinic last week that made me remember just how important it is for any patient to be aware of, and take care of themselves and their healthcare. Ever since I had my kidneys removed nearly three years ago I have been using the anti-emetic Zofran on a regular basis. No other ant-emetic that I've tried does what Zofran does. Anyhow, at dialysis I usually get a dose when I start and stop treatment. All the usual nurses at the clinic know this by now.

About a week ago, a substitute nurse--who is terrible to begin with--was working the clinic. At the end of my session I asked for Zofran, and she came in and promptly stated, "I have your Benadryl." My immediate reply was, "That had better NOT be Benadryl! Because if it is, I'll sleep for hours, and my wife will be pretty mad!"  She replied, "No, I'm pretty sure it is." "Are you sure?" to which she replied, "Yeah, I think so."

My final reply was, "Alright...we'll see."

Luckily, it was Zofran.

I knowingly allowed her to proceed for two reasons...1) Aside from a very long sleep, the side effects would be minimal. 2) Part of me wanted to watch this terrible nurse screw up so that she would no longer work at the clinic if she was wrong.

My point is this...

That nurse should have checked the med to verify exactly what it was. She was completely irresponsible for not going back to the nurses station and checking for herself.

Your healthcare is entirely in YOUR hands! Educate yourself about every facet of everything you are going through...Meds, Treatments, Procedures, etc.

   -Ask questions about anything you don't fully understand.

   -Get online and research things you've discussed with your physicians.

   -Know the side effects of any meds you are prescribed.

   -If you are uncomfortable with anything, take control and ask questions, understand     procedures, ask surgeons to clarify anything you don't comprehend prior to surgeries.

   -Educate, Educate, Educate!

Only YOU can know what is best for you! If you have any concerns, fully discuss them with your doctors. Nervousness is one thing going into any procedure or treatment...Fear is quite another. Ask as many questions as you want.

The more you know, the easier everything becomes when dealing with long-term health issues.  (THAT is absolute truth!)

Anyhow, that's all I have for today. May each of you have a successful, wonderful week ahead! Continue to do and be your very best every single day!

Good Health to All!

ScottW

25 July 2016

Just a quick note today...

Due to the rather poor labs that were drawn earlier this month, the [dialysis]  clinic Dietitian had all my labs redrawn to verify the numbers. While I won't do the comparative illustration again, I will give the labs and a +/- number.

*Albumin 4.00 (-0.20)

*Hemoglobin 10.50 (-0.70)

*Calcium Corrected 10.3 (No Change)

*Phosphorous 4.00 (-1.80)

*PTH Intact 263 (+44)

*Potassium 5.30 (-0.50)

*spKdt/V 1.67 (No Change)

The only lab value that is now +/- accepted range continues to be the Calcium Corrected. However, that value is over the top end of the range by just 0.10, which is minimal. The dietitian has ordered a lessened Vitamin D injection during my dialysis Tx's. This should help lower that lab value.

Overall, I've been getting a break from my headaches since my last post. I've had a few days that found minimal or no headaches at all for most of the day. Even this past Tuesday--usually my worst headache day, due to the large post-weekend draw at dialysis--the worst of my headache was immediately following dialysis. After waking from my post-D sleep, the headache was greatly reduced...something I will never complain about!

My sleeping hours average and my daily food intake are unchanged from two weeks ago.  Going along with both, my energy level continues to be lower, as well.

I've been having an uptick in nausea again. However, with as poor as my appetite has been, this really comes as no surprise. The best I can do at this point is to try and manage the nausea through snacking/eating and using Zofran, Tums, etc as needed.

Those are the highlights of this update. Again, just a quick note today as I am not feeling well, at all. Noting specific; it's just one of those day that I just feel sick.

Until next time...

Good Health to All!

ScottW

11 July 2016

A new--and unexpected--development with my Artificial Graft. I'll get to that in a bit...

Dialysis Weights:

23 Jun 16

Starting Weight:  103.4 kg

Ending Weight:  99.9 Kg

Water Removed:  3.50 Kg

Start BP:  196/121   End BP:  138/83

25 Jun 16

Starting Weight:  102.8 Kg

Ending Weight:  99.3 Kg

Water Removed:  3.50 Kg

Start BP:  187/117   End BP:  122/84

28 Jun 16

Starting Weight:  104.2 Kg

Ending Weight:  100.3 Kg

Water Removed:  3.90 Kg

Start BP:  173/102   End BP:  136/89

30 Jun 16

Starting Weight:  103.0 Kg

Ending Weight:  99.6 Kg

Water Removed:  3.40 Kg

Start BP:  167/105   End BP:  102/70

02 Jul 16

Starting Weight:  102.2 Kg

Ending Weight:  99.2 Kg

Water Removed:  3.00 Kg

Start BP:  160/109   End BP:  123/86

05 Jul 16

Starting Weight:  103.5 Kg

Ending Weight:  100.1 Kg

Water Removed:  3.40 Kg

Start BP:  195/109   End BP:  143/82

07 Jul 16

Starting Weight:  102.0 Kg

Ending Weight:  99.2 Kg

Water Removed:  2.80 Kg

Start BP:  179/107   End BP:  122/75

09 Jul 16

Starting Weight:  101.8 Kg

Ending Weight:  99.7 Kg

Water Removed:  2.10 Kg

Start BP:  164/106   End BP:  110/84

For the most part, my BP's have looked pretty good. That spike of the elevated starting BP's was a mystery. I wasn't doing anything to precipitate the increase--i.e. extra fluid gain--so I have no idea why that jump happened. As it is unusual, I will note any further high starting BP's and discuss it with my Nephrologist.

I crashed once at the very end of treatment on Tuesday, 05 July. My weight loss was normal, as was my Tx. Why I crashed is a total mystery. I stood up to get my final post-D BP reading and began to almost instantly feel dizzy, nauseated, have cold, clammy skin and feel as if I would pass out--all classic S/S's of a crash.

I immediately laid down, called for a nurse and was infused with half a liter of NS (Normal Saline). This eradicated all the symptomology of the crash and within ten minutes I was up and moving around again. As it ended up, I was the 0.50 Kg over my goal (of 99.5 Kg), the same amount I was infused with following my little crash event.

The only factor different that might have contributed to the crash was the fact that I started using my new Artificial Graft that day. However, the treatment was normal and quiet; so just why I crashed is again, unknown.

July 2016 Labs: 

*Albumin (21 Jun): 4.20 g/dL     (+0.40 from 17 May)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (05 Jul): 11.2 G/dL    (+1.20 from 21 Jun)
  (A Measure of Anemia)

*Ca Corrected (05 Jul): 10.3 mg/dL     (+0.40mg/dL from 07 Jun)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (05 Jul):  5.80 mg/dL    (+1.40 mg/dL from 07 Jun)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (21 Jun):  219 pg/mL     (-03pg/mL 17 May)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (05 Jul):  5.8 mEq/L    (+0.10 mEq/L from 21 Jun)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (05 Jul):  1.67     (-0.12 from 07 Jun)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher  

As seen in the numbers above, my labs are not especially good this month. Since I am very good at doing what I should with my renal diet, I do not know why my labs look this bad. As always, I am especially careful with my potassium intake, and with taking my Renvela--the Phosphorous binder. As I've discussed many times previously, the K+ (potassium) will jump around no matter what I do; and, I am always cognizant of my phosphorous intake. Why that one is off is a unknown. The real mystery though is the Calcium Corrected. I have zero clue as to why that is elevated. Hopefully, July will see a reduction in my labs where needed.

Now, the news about my Artificial Graft. I already told you I have begun using the graft this past week (on 05 July). On Saturday, sometime during my dialysis session, I began to have leakage into my arm. I do not know if this was from the needle insertion or maybe a slight infiltration from when the graft was canulated at the start of treatment. However, I DO know that the leakage came from the venous return end of the graft. As a result, I have bruising in my arm that looks like I had a needle infiltration of my old fistula.

Here's a picture taken just now:

     (ScottW's arm contusions following graft leakage on 09 July 2016.) Taken 11 Jul 16.

The contusions (bruising) goes from the base of my thumb to about four inches above my elbow, covering about 2/3's of the arm in that area. Most of it isn't too bad as far as pain. The worst of it is that the arm is purple. Ah well, it's happened before, and will likely happen again.
Luckily, the chest catheter is still emplaced, so I will be using that once again until the arm heals enough.
You may be asking why I didn't know the leakage was happening. That is very simple to answer... I simply had no idea. There was no bump like with a fistula infiltration, no obvious signs at first, and not even any real signs until very late in treatment because I had fallen asleep about two and a half hours into the session, and when I awoke, I noticed my arm felt tight, was moderately painful to move, and only a little bruising was evident. As soon as I saw the bruising I informed my tech. Unfortunately, I awoke just minutes before the end of my dialysis. If I had awoken sooner, the impact of the leakage may have been less, but probably not by much.

Let's see, what else...

My appetite hasn't improved much since my last entry. I am barely eating one decent meal per day, and generally snacking only the rest of the day. Everything is just looking unappetizing. I don't know why; it just is. Even my post-D lunches are not being finished; which is a rarity.

Naturally following a poor appetite, my energy is also decreased--No mystery on this one! However, I will generally push through the lack of energy if I need to. And going hand in hand with these is an increase in sleep. The last couple of weeks I haven't been napping much, but my sleep has been increasing. Last Tuesday, my pre and post-D sleep totaled twenty hours...no kidding. I can't complain about the sleeping. After all, it was because of lots of sleeping that I received my disability judgment in the first place. I just look at it as earning my paycheck!  :o)

The headaches continue. LOTS of TMD involvement, too. How do I know? Because my R jaw is clunking... a lot. This is a major indicator of TMD induced headaches; and has been for going on 31 years.

I think that's about everything for today. If not, I will always add anything on the end of this entry.

...yep...that's it...for now. :o)

Good Health to All!

ScottW