Friday, March 21, 2014

21 March 2014

As promised...


Dialysis Weights:

06 Mar 14
Starting Weight:  104.6 Kg
Ending Weight:  101.1 Kg
Water Removed:  3.50 Kg

08 Mar 14
Starting Weight:  104.9 Kg
Ending Weight:  100.8 Kg
Water Removed:  4.10 Kg

11 Mar 14
Starting Weight:  105.6 Kg
Ending Weight:  101.9 Kg
Water Removed:  3.70 Kg


13 Mar 14
Starting Weight:  105.8 Kg
Ending Weight:  102.0 Kg
Water Removed:  3.80 Kg

15 Mar 14
Starting Weight:  105.5 Kg
Ending Weight:  101.8 Kg
Water Removed:  3.70 Kg

17 Mar 14
Starting Weight:  105.2 Kg
Ending Weight:  100.2 Kg
Water Removed:  5.00 Kg

20 Mar 14
Starting Weight:  106.0 Kg
Ending Weight:  101.2 Kg
Water Removed:  4.80 Kg

Aside from my last two weigh-in's, my weights are remaining consistent. 105 Kg seems to be the point at which I have fluid infiltrating my lungs. I was really surprised at yesterday's weigh-in. I was expecting about a four kilogram increase. When the 5.8 Kg showed, I was gob smacked.
I still don't understand how I gained that much weight. My accounting of my fluid intake was 3.4 Liters--about 3.50 Kg. Add in weight for food consumed, and it should have been between 4-4.5 Kg. Ah well... I'll keep trying!

Labs are in and most are good.

*Albumin (17 Mar): 4.40 g/dL (+0.30 g/dL from 21 Jan)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (17 Mar):  10.9 g/dL  (-0.30 g/dL from 04 Feb)
  (A Measure of Anemia)

*Ca Corrected (03 Mar): 9.60 mg/dL (+0.70 mg/dL from 04 Feb)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (08 Mar):  6.80 mg/dL (+1.70 mg/dL from 08 Feb)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (17 Mar):  245 pg/mL  (+26 pg/mL from 21 Jan)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (17 Mar):  5.7 mEq/L     (+0.60 mEq/L from 21 Jan)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (03 Mar): 1.34   (-0.19 from 04 Feb)

  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher
(I've been having numerous blood draws this month, so the dates shown will be all over the place, instead of consistent with each test.)

As far as the Phosphorous and Potassium, I have no idea why these are out of whack. I've been really good about not eating phosphorous rich foods, have been taking my binders as instructed, and rarely eat potassium heavy foods. I spoke with the clinic nutritionist yesterday, and she stated that I'm doing things right with my diet; these numbers will just bounce around for no good reason. She said to just keep doing what I have been.

Two weeks ago, after yet another bout of intense nausea and vomiting, I requested a better anti-emetic, and was prescribed oral Zofran. (This is the same injectable anti-emetic I get during dialysis, if needed.) My usual anti-emetic, Promethazine, has been ineffective in curbing the intense nausea when it strikes; so I had to get something even better. Zofran is regularly prescribed to Chemotherapy patients to control their nausea and vomiting. My own experience with the med [at dialysis] told me it was fantastic. Yesterday, I had the opportunity to try it out, and it did not disappoint me at all! Once it started working, the emerging nausea was gone, and it never developed into anything worse. Granted, it took about thirty minutes to kick in; but once it did, the symptoms completely disappeared!  

Thank goodness!!!

A fellow dialysis patient had a donor transplant this past Tuesday, and I went to see him in the same hospital I'll be getting my transplant at. Just one day after surgery he was already looking great! His skin color was better, his face was happier and his countenance was brighter. He (Shawn) stated that he felt great, and that his new kidney kicked in almost immediately.
Shawn stated that, as I've been told, he gained 20 pounds due to the massive infusion of steroids needed to suppress the body's immune system so the kidney won't reject. By the time he goes home, Shawn will be taking far less steroids, and his weight gain will all be gone through urination.
It was good for me to see and talk to Shawn. Getting as much info in advance has helped me tremendously thus far; so getting first hand knowledge about a transplant is essential to my preparing for my own transplant!
If you are awaiting any transplant, I strongly urge you to talk with someone who has been through the process. Their insights and experience will give you peace of mind as you enter what can be an incredibly scary time.

Still no incidences of diarrhea. It's been nearly two months now since the last incident. Again, not that I'm complaining; but I'd rather tolerate diarrhea than have fluid buildup in my lungs. Not sleeping and having trouble breathing simply isn't any fun whatsoever. Luckily, the DiB thing is almost completely within my ability to control.

As I alluded to in yesterday's brief note, my wife and I moved condo's. We're in the same building, just up one floor to a vastly quieter place, and it has a superior view, as well. The move wasn't overly difficult, and we had a week to get it all done. Nevertheless, it exhausted me, and I've been pretty much worthless since Sunday--when we finished cleaning the other place. In another day or two I should be better.

That's all I can remember for now.

I eagerly await the call out of the blue that signals my transplant surgery.

Good Health to All!

ScottW

Tuesday, March 4, 2014

04 March 2014

It's been too long since my last blog, so let's get at it...

Dialysis Weights:

20 Mar 14
Starting Weight:  106.7 Kg
Ending Weight:  102.1 Kg
Water Removed:  4.60 Kg

22 Mar 14
Starting Weight:  105.6 Kg
Ending Weight:  101.7 Kg
Water Removed:  4.10 Kg

24 Mar 14
Starting Weight:  105.9 Kg
Ending Weight:  102.2 Kg
Water Removed:  3.70 Kg

27 Mar 14
Starting Weight:  106.6 Kg
Ending Weight:  102.2 Kg
Water Removed:  4.40 Kg

01 Mar 14
Starting Weight:  105.4 Kg
Ending Weight:  101.5 Kg
Water Removed:  3.90 Kg

03 Mar 14
Starting Weight:  105.6 Kg
Ending Weight:  101.3 Kg
Water Removed:  4.30 Kg

As you see, my bottom weight is getting lower. Officially, my dry weight is now 101.5 Kg. (If you'll remember, before my nephrectomy, my dry weight was 104.3 Kg.) Why the change?
Two reasons--
   1) It helps my Blood Pressure be better.
   2) It is reducing fluid in my lungs.
As of yesterday's Tx, the fluid in my lungs was gone, and my BP is lower than it has been since early December. I will continue using O2 during dialysis, as this helps reestablish the proper air pressure within the lungs.
I'm still getting restricted breathing about two days after my last Tx. With the fluid gone [for now], I'm hoping I won't be dealing with this again anytime soon. We'll see.

As for my dry weight, I am looking to be at around 100 Kg as my goal. That should help keep the fluid out of my lungs, and keep my BP in a proper range. I'll keep you updated.

Also following last night's Tx, I got a full night of sleep for the first time in several weeks. The restricted breathing was keeping me from getting that sleep as I would awaken frequently gasping for air. And sleeping in a bed was near impossible as laying down only exacerbated the breathing issues. So, I slept in my recliner a lot...well, I use the term "sleep" quite loosely because the three or so total hours I'd get each night hardly qualified as sleep. Let's call it, multiple twenty or so minute naps that totaled about three hours over the course of a full day.

My post-dialysis headaches continue to be an issue. I know that these are a direct result of the fluid shift that occurs during Tx, and once I've got a kidney, they will never bother me again. Yes, I'll still be dealing with the TMD headaches--for the rest of my life!--but at least I won't have these nasty dialysis headaches on top of them.
In case you're wondering, before the onset of the kidney disease, my TMD was under control. I hadn't had a nasty blowout headache in ten years. Anytime I got a headache--or felt as if one was coming on--I'd pop in my mouth guards at night and awaken the next day with no pain at all.  To manage what small headaches I did get, I'd use a regimen of regular Tylenol or Tension Headache Excedrin. Add in my relaxation techniques and awareness of body positioning, and you have TMD control. Hopefully I'll get back to that once again after all of this is said and done. It took me literally years to get the TMD under control. Let's hope that it only take a few weeks to achieve.

The past few weeks I haven't had even a single incidence of diarrhea. While a very good thing, according to my doctor, the lack of fluid expulsion from my body likely aided the onset of fluid into my lungs. So, a good and a bad thing.

Since the onset of that pulmonary fluid, I also haven't had any vomiting. This is definitely a great thing! My whole body gets into the action and it just wears me out. All that vomiting I did a few weeks ago really took its toll.

My abdomen continues to heal from the surgery. I still get twinges of pain; and if I over do things, the incision site really hurts. Every once in a while I'll look at those scars (5 in total--Incision, 2 Lap, 2 drains)--and I am amazed that I am walking around, living and breathing, without two of my seven Vital Organs. It's incredible what modern medicine can achieve!

Oh...I forgot to tell you!

On advice from the Head Nurse at my dialysis clinic I went to see a Vascular Surgeon about my fistula--where we connect dialysis through. I've been having problems with leakage during Tx, and then with proper clotting after the needles are removed. Last week I held pressure for forty minutes and I STILL popped the clots. I ended up taking an arm clamp home with me that stayed on my arm for another hour!

Anyhow, the arm was scanned with Ultra Sound. It turns out that my fistula has closed in on itself about three inches below the elbow with a huge clot. So, now the blood flow has diverted to other veins in my lower arm, creating a spider web of enlarged smaller vessels in order to accommodate the increased blood flow back to the heart.
In the short term, this I no big deal. The clot poses no danger to my heart whatsoever, and the vessels carrying the increased blood flow are compensating [for the fistula] just fine. In the long term, I have three options:
1) Leave everything in place. The fistula should hold up.
2) Place a new fistula on my R arm.
3) Move a deep vein from my L bicep to a shallower position, and hook it into the existing fistula by cutting out the clotted section.

For now, we're just going with option one. It can always fail, in which case a central line would be placed to accommodate dialysis; then, a second fistula would be established through either option two or option three. If either scenario happens, I will certainly let you know. All of this is moot however, if I get a kidney before the fistula fails. In that case, the fistula, no longer in use, would simply continue to flow as it is now. In the event it has to be used again, then the vessel will be reevaluated for viability.

I think that's all....

Have a great week, everyone!

Good Health to All!

ScottW