18 October 2013

Lots to talk about today, so I'll get going with my usual dialysis weights...

10 Oct 13
Starting Weight:  105.6 Kg 
Ending Weight:  103.9 Kg
Water Removed:  1.70 Kg

12 Oct 13
Starting Weight:  106.0 Kg
Ending Weight:  104.1 kg
Water Removed:  1.90 Kg

15 Oct 13
Starting Weight:  107.1 Kg
Ending Weight:  104.1 Kg
Water Removed:  3.00 Kg

17 Oct 13
Starting Weight:  106.0 Kg
Ending Weight:  103.8 Kg
Water Removed:  2.20 Kg

Aside from last weekend, my weight stays consistent. I work hard every day to achieve this; but it's definitely worth the effort as big swings in weight (pre and post-D) tend to cause bad cramping after treatment. A great incentive to do well!
Speaking of cramping, I don't remember if I ever told you about my efforts to reduce cramping --besides weight control. I was talking with one of the dialysis clinic nurses (in August, I think) about reducing my cramping. Since my labs are great all of the time, he suggested I try drinking a cup or so of dill pickle juice before dialysis. I really can't do that--not with my stomach!
Instead, I decided to try eating a dill pickle spear just before treatment. The intent here is because I rarely consume salt/sodium, the dialysis might actually be causing a sodium deficit, thereby causing cramping that might not otherwise be present in other patients. (After all, your body DOES need a certain amount of sodium every day. Most times, there is plenty of sodium in veggies, meats, etc to meet your daily needs. Since I don't eat processed foods, my sodium intake is lower than most Americans. However, with sodium being filtered off, that needed volume dissipates leaving you in sodium deficit.)
Anyhow, after my first try at this, I had no cramping after dialysis...possibly a coincidence. I tried again the next treatment; same result. I now eat one half a dill pickle prior to every Tx, and I have yet to experience any cramping after dialysis. I will continue to do this for as long as I am on dialysis.
Now, this works for me; but it may not work for anyone else. Again, I am affected by the sodium deficit because I follow my dietary guidelines, and eat only freshly prepared meals, relying on the naturally existing sodium to meet my daily needs--I've been doing this for years, by the way. (I just prefer foods with no added salt! I have since I was a teenager. Try it yourself! Food tastes better!) If you are eating unhealthy levels of sodium, this approach is NOT for you! As I've stated before, listen to your body. It will always tell you what it needs to stay healthy!
 My Latest Labs:


*Albumin (17 Sep):  4.70 g/dL (+0.10 g/dL from 20 Aug)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (15 Oct):  11.2 g/dL  (+0.10 g/dL from 03 Sep)
  (A Measure of Anemia)

*Ca Corrected (08 Oct): 9.70 mg/dL (+0.40 mg/dL from 03 Sep)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (08 Oct):  4.60 mg/dL (+ 0.1 mg/dL from 03 Sep)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (17 Sep):  161 pg/mL  (-14 pg/mL from 20 Aug)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (17 Sep):  3.9 mEq/L (-0.30 mEq/L from 20 Aug)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (08 Oct): 1.38   (-0.13 from 03 Sep)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher
Overall, my labs are still great! The drops or rises in levels are indicative of reducing Renal function. However, all of the results are still within the target ranges, in spite of the red numbers. Thank goodness I'll be getting my kidneys out soon!

While I'm on the subject of kidney removal, I had my latest visit with my Nephrologist yesterday. He said that I am doing exceptionally, and that I am, and I quote, "A terrific patient! (stated emphatically!) I wish all of my patients were as good as you are!" I will certainly take that kind of praise from any physician!
Anyhow, I asked my doc about life after the Bilateral Nephrectomy. I stated that, as always, I want to know what to expect ahead of time rather than worrying, wondering, etc.  (My Nephrologist always appreciates this about me!) So, here's what he said:

-The likeliest surgical complication will be bleeding. Infection is always possible; but again, not likely.

-While a six week recovery (post-surgery) is given, the typical nephrectomy patient takes about three months to heal.

-I should expect my weight to increase post-surgery due to edemic increase (natural with any surgery). Additionally, with the method currently employed for kidney removal, most of the fluids inside the kidneys will be released into my body. Over time, the dialysis treatments will take all of that water weight out. Total decrease time for weight depletion should be about two months.

-Dialysis time post-surgery will increase! Even at the reduced function of my kidneys, they are providing benefit. Once out, that benefit is gone, and longer dialyzing time will be required. My doc anticipates an extra 30-60 minutes from my current dialyzing time of four hours. How my body responds will dictate any adjustments in time on dialysis.

-My regimen of meds may change post-surgery. I will be on the same meds initially, but my BP (blood pressure) may actually drop, thereby reducing the meds I am on. This one would be nice! Again, every patient is different, so what I need will simply be what ends up happening on this.

That's it. I even asked about increased diarrhea (No!), increased edema (possibly), dietary changes (none), etc. Every answer came back as either 'no,' or 'not likely.'
I expressed to my doctor that I hope that my headache will reduce (or be gone entirely!), and that I also hope that without the back pain and feeling ill all the time, that I will hopefully get started walking every day to increase my strength, help reduce my weight, etc. My doctor received that statement with enthusiasm and a smile!

So, things to look forward to!

As I previously stated, I have the surgical consult coming up at the end of the month.
I'll keep you updated with all the info a day or so afterwards.

As far as how I am doing, here's the latest...

My energy level from day to day is nearly gone. No matter how long my naps are, how long my sleep goes, I awaken as exhausted as when I went to sleep. There seems to be no relief from the exhaustion, at this point. The challenge shifts to my keeping my brain in a good place in spite of both feeling lousy and the extreme fatigue I feel 24/7.  And it is definitely challenging, too!

My jaw continues to relax. There is now minimal pain when I chew, and I can open my mouth a little wider. I expect this slow healing to keep going until I have my normal R.O.M. (Range of Motion) in my jaw once again. I do have my one month dental follow-up this coming Wednesday. I'll tell you all bout the relevant info.

(It sure seems like I've got a lot of doctor appointments lately, and well...I do! And from here until I after my transplant, I'll have a LOT more, too! Woo-Hoo!)

My appetite seems to be improving. Although I still easily get appetite fatigue, at least I am eating more, when I eat. Still no breakfast--probably never will be; but my other two meals are better. I'll take any improvement here!

The headache is the same as always and is now approaching 48 months in duration. Now that the added TMD complications that resulted from all the dental work are subsiding, the headache is returning to its normal intensity and pattern. Another win, as far as I'm concerned!

My dreams continue to be in my control. It's now been a number of weeks since I had a bad dream. A shift in my thinking with the Nephrectomy coming up may be helping this, too. I am finally looking forward to an event, rather than just trying to get through from day to day. In either case, yet another win!  :o)

I am getting excited about everything, now. My kidneys will be out soon; I'll be on the Active Transplant Recipient List soon; I now have hope in returning to a normal life... It's been a long haul...and more to go...but at least there is now Hope. A Very Good Thing!

Good Health to All!

ScottW