To start, here are the dialysis weights since 30 Aug:
30 Aug
Starting Weight: 105.2 Kg
Water Removed: 1.70 Kg
Ending Weight: 103.5 Kg
01 Sept
Starting Weight: 104.8 Kg
Water Removed: 1.70 Kg
Ending Weight: 103.1 Kg
04 Sept
Starting Weight: 105.8 Kg
Water Removed: 2.70 Kg
Ending Weight: 103.1 Kg
06 Sept
Starting Weight: 104.7 Kg
Water Removed: 1.20 Kg
Ending Weight: 103.5 Kg
08 Sept
Starting Weight: 105.1 Kg
Water Removed: 1.90 Kg
Ending Weight: 103.2 Kg
We are trying to make 103.5 Kg's my consistent dry weight. I have the fewest body aches, the fewest cramps, and the least negative effects from the dialysis at 103.5.
I am still waiting for my insurance to preauthorize the lidocane cream for my fistula arm. Once it is, I will apply it 45 minutes-1 hour before dialysis, wrap the lower arm in cellophane, and let the cream soak in. By the time canulation arrives, I am told the needle sticks will be pain free and the stinging will be absent.
Overall things with the dialysis are improving. I continue to notice the headache as being reduced from its nastiness of pre-dialysis. The pain level has dropped to about a 7.5, and my T3 use has dropped accordingly as well. On dialysis day I take more (4-6) because the headache increases during the treatment for some reason and stays all day. However, on my off days, the usage drops to about 3 per day. I've even had a couple of days that I took only one tablet! Hopefully, this trend will continue.
My energy level continues to improve. Overall, I would estimate that I have about 5-7% more energy since starting the treatments. It's not a lot, but it is an improvement.
This past week I seem to have been more tired than usual. I don't know why this is. I am sleeping fairly well at night, my naps are reduced in length and frequency, and I am still eating a bit more than what had become normal. It certainly could be my kidneys continuing to deteriorate. I do know that I've had that ill feeling a lot the past month or so. It wouldn't surprise me one bit.
The labs that the dialysis center focuses on are consistent from week to week. The numbers they are looking at include:
-Albumin 4.7 g/dL (4.0 g/dL min.)
*(from the Davita website) "Albumin is the most common protein found in the blood. It provides the body with the protein needed to both maintain growth and repair tissues. During a dialysis treatment, the albumin in your blood also helps with fluid removal. It helps “pull” extra fluid from swollen tissues back into the blood, where it can then be removed by the dialyzer."
-Hemoglobin 11.2
*(from Davita) "Anemia happens when your body is not making enough red blood cells. Red blood cells carry oxygen to all the cells in the body. The body’s cells use oxygen to change the glucose we get from food into energy. Fewer red blood cells means less oxygen is sent to the cells. Without enough oxygen, your tissues and organs have less energy to perform their jobs. Untreated anemia can affect major organs like your heart and brain."
**My latest labs show my RBC at 32.2, well below the normal range of 45-60. This shows I continue to be anemic. The Hemoglobin is simply another measure of the RBC.
-Calcium Corrected 10.0 mg/dL (8.4-10.2 mg/dL)
* (from Davita) "Calcium is an essential mineral that is controlled in the diets of people on dialysis. According to the National Kidney Foundation, people with chronic kidney disease (CKD) should not exceed 2,000 mg of calcium per day. This includes not only the calcium present in food, but also that in medications and supplements such as calcium-based phosphorus binders. It’s important to work with your physician and dietitian and learn how to maintain a healthy level of calcium."
-Phosphorus 4.9 mg/dL (3.0-5.5 mg/dL)
*(from Davita) "Phosphorus is a mineral found in the body. About 85% of the phosphorus in the body is in bones. Phosphorus is the body’s next most abundant mineral after calcium.
Because unhealthy kidneys are no longer able to remove phosphorus from the blood and get rid of the excess in urine, high levels of phosphorus (hyperphosphatemia) is a problem for people with stage 4 and 5 kidney disease, especially stage 5 (also known as end stage renal disease or ESRD).
High levels of phosphorus in the blood can cause:
- bone and heart problems that lead to hospital stays and in some cases death
- too much PTH to be released, which over time can weaken bones and make them more likely to break and develop renal osteodystrophy
- low blood calcium, which causes calcium to be taken from the bones
- calcification or hardening of tissues when phosphorus and calcium form hard deposits in the heart, arteries, joints, skin or lungs that can be painful and lead to serious health problems
- bone pain
- itching"
-PTH Intact 118 pg/mL (150-600 pg/mL)
*(from Davita) "PTH stands for parathyroid hormone. If you are on dialysis, you will recognize it as one of your routine blood tests. This hormone is made by your parathyroid glands. These small glands are located behind the thyroid gland in your neck.
The key purpose of the parathyroid glands is to keep the calcium and phosphorus in the blood at a constant, normal level. If, for example, the blood calcium becomes low, the parathyroid gland will respond by secreting more PTH. This extra PTH then will pull calcium from the bones, correcting the low blood level. This give-and-take response works well until kidney failure begins to occur."
-Potassium 4.2 mEq/L (3.5-5.5 mEq/L)
*(from Davita) "Potassium is a mineral that controls nerve and muscle function. One very important muscle—the heart—beats at a normal rhythm because of potassium. In addition potassium is necessary for maintaining fluid and electrolyte balance and pH level. In order for potassium to perform these functions, blood levels must be kept between 3.5 and 5.5 mEq/L. The kidneys help keep potassium at a normal level. Potassium levels that are too high or too low can be dangerous."
-URR 74% (65% min)
*(from Davita) "Healthy kidneys work 24 hours a day, seven days a week. When kidneys stop working, dialysis does this job, but it only does some of the work. It is possible to live a long and healthy life receiving dialysis three times a week by ensuring that your blood is optimally cleaned during each treatment.
The dialysis center uses a test called urea reduction ratio, or URR, to show how well your blood is cleaned during your treatments. Every month you will see your results on your nutrition report. The goal is a score of 65 percent or better on the URR test."
*As time goes on you will see these numbers fluctuating or dropping. It is just a normal course as the kidney disease progresses. I will try to keep you current on these numbers from week to week.
The bilateral flank pain seems to be worsening...or, I am just getting tired of it so the pain only seems worse. In either case, I am more uncomfortable than ever whether sitting, laying or even standing. Walking exacerbates it of course, so I am depending on the cane more than ever because of that.
I have the Transplant Evaluation Appointment this coming Wednesday, 12 Sept. It will be an all day affair. There will be about a half dozen tests as well as interviews with the Transplant Team Specialists including a surgeon, a nephrologist, a financial counselor, a psychologist, etc. I will write about as much of it as I can remember on either Wednesday evening or on Friday.
That's about all I can think of writing tonight.
Good Health to All!
ScottW
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