On 23 March I saw my Vascular Surgeon again. The Artificial Loop Graft was mapped and everything looks terrific! The flow is at 1400+ (a phenomenal rate!), the line is clear, and was ready to use. The surgeon gave the go ahead to start using the line at dialysis, which I did the very next day for my Thursday morning Tx.
On an aside,
My vasculature is a bit odd, which is one reason that Bovine Graft failed. Anyway, the Arterial and Venous sides of the graft are reversed from pretty much every other graft patient. My arterial is on the thumb side of the arm, and the venous is on the pinky side. Again, this is reverse from how it ends up on most every other patient. So, when I first used the graft, it was vital that I made this distinction with the dialysis techs so the correct needle was placed on the correct side of the loop. If not placed properly, the needles will simply clean the same small amount of blood potentially hundreds of times, but leave the vast majority of blood untouched. So, just a bit important...
Anyhow, my first use of the Artificial loop Graft at dialysis was a complete success. The venipuncture was quick, easy and, well, better as far as pain; but I won't say it was painless. After all, sharp needles will hurt no matter what. However, it isn't like those blunt needles getting shoved through your skin!
The treatment saw me run at 450--the fastest possible during Tx--the entire four and a half hours. The worst part of the session was not being able to move my arm. With the Central Line I had gotten used to using both arms for whatever. Now, everything must be done using one arm again. It'll take some getting used to...again. I did it for three and a half years before this whole Phoenix debacle; and I will get there once more.
As a result of the higher flow, my blood is being cleaned an extra 4-6 times each session, which results in cleaner blood. Since starting the graft I have slept better, my appetite is a little better, my labs are better, I don't feel quite so dragged out afterwards and the cramping has been reduced as well. This last part is also due to the fact that I have actually upped my Dry Weight to 96.5 Kg.
One month ago my Nephrologist took me off of the BP med Atenolol (a Beta Blocker) entirely--I was only on 25 mg 2x/day anyhow. It takes between 3-4 weeks for the effects of that med leave the body entirely. During the second to third week without the Atenolol, my BP and Pulse began to swing wildly. This is a normal side effect of losing that med. Plus, without the med it became clear that my Dry weight was too low, so I began gradually upping the weight until I hit 96.5 Kg (+2.5 Kg over my previous dry weight). At 96.5 I am not cramping, my BP is more stable, and my pulse has come down to an acceptable level. Right now, it is averaging about 85 BPM. As time goes on past the 4 week mark, it should continue to drop to its normal BPM of about 62-64.
So, I now have just three more treatments (Tx's) with no problems using the graft and I can then schedule the removal of the Central line! I can hardly wait!
March 2016 Labs:
*Albumin (22 Mar): 4.10 g/dL (+0.20 from 19 Jan)
(A measure of Protein in the blood) NR (Normal Range) 4.0 g/dL or Higher
*Hemoglobin (22 Mar): 10.9 G/dL (+1.20 from 08 Mar)
(A Measure of Anemia)
*Ca Corrected (02 Mar): 9.80 mg/dL (+0.30mg/dL from 05 Jan)
(A measure of Heart and Bone health) NR 8.40 to 10.20 mg/dL
*Phosphorous (12 Mar): 4.50 mg/dL (-0.40 mg/dL from 02 Feb)
(High Phosphorous affects the health of your Heart and Bones) NR 3.0 to 5.5 mg/dL
*PTH Intact (22 Mar): 393 pg/mL (+8.0 pg/mL 16 Feb)
(A measure of Vitamin D absorption and bone and tissue health) NR 150 to 600 pg/mL
*K+ (22 Mar): 5.6 mEq/L (+0.50 mEq/L from 01 Mar)
(Proper potassium levels keep your nerves and muscles working well) NR 3.5 to 5.5 mEq/L
*spKdt/V Dialysis (08 Mar): 1.61 (+0.20 from 02 Feb)
(A measure of the effectiveness of dialysis and blood filtering.) NR 1.20 or Higher
(A measure of Protein in the blood) NR (Normal Range) 4.0 g/dL or Higher
*Hemoglobin (22 Mar): 10.9 G/dL (+1.20 from 08 Mar)
(A Measure of Anemia)
*Ca Corrected (02 Mar): 9.80 mg/dL (+0.30mg/dL from 05 Jan)
(A measure of Heart and Bone health) NR 8.40 to 10.20 mg/dL
*Phosphorous (12 Mar): 4.50 mg/dL (-0.40 mg/dL from 02 Feb)
(High Phosphorous affects the health of your Heart and Bones) NR 3.0 to 5.5 mg/dL
*PTH Intact (22 Mar): 393 pg/mL (+8.0 pg/mL 16 Feb)
(A measure of Vitamin D absorption and bone and tissue health) NR 150 to 600 pg/mL
*K+ (22 Mar): 5.6 mEq/L (+0.50 mEq/L from 01 Mar)
(Proper potassium levels keep your nerves and muscles working well) NR 3.5 to 5.5 mEq/L
*spKdt/V Dialysis (08 Mar): 1.61 (+0.20 from 02 Feb)
(A measure of the effectiveness of dialysis and blood filtering.) NR 1.20 or Higher
This is the last lab report using the catheter. Next month's labs should look even better. I hope to be sharing that news next month.
As far as the weights, remember that I will show an upward trend to compensate for the lack of a beta blocker in my system.
(Sorry...I have a bit of Weights to catch up on...)
(Sorry...I have a bit of Weights to catch up on...)
Dialysis Weights:
19 Jan 16
Starting Weight: 98.6 Kg
Ending Weight: 94.3 Kg
Water Removed: 4.30 Kg
Start BP: 156/115 End BP: 93/61
21 Jan 16
Starting Weight: 97.0 Kg
Ending Weight: 94.2 Kg
Water Removed: 2.80 Kg
Start BP: 143/100 End BP: 100/61
23 Jan 16
Starting Weight: 98.9 Kg
Ending Weight: 94.9 Kg
Water Removed: 4.00 Kg
Start BP: 142/96 End BP: 140/105
26 Jan 16
Starting Weight: 97.9 Kg
Ending Weight: 94.2 Kg
Water Removed: 3.70 Kg
Start BP: 156/95 End BP: 93/63
28 Jan 16
Starting Weight: 96.4 Kg
Ending Weight: 93.9 Kg
Water Removed: 2.50 Kg
Start BP: 143/87 End BP: 100/61
30 Jan 16
Starting Weight: 96.2 Kg
Ending Weight: 94.7 Kg
Water Removed: 1.50 Kg
Start BP: 152/91 End BP: 97/64
02 Feb 16
Starting Weight: 98.7 Kg
Ending Weight: 94.1 Kg
Water Removed: 4.60 Kg
Start BP: 162/107 End BP: 127/96
04 Feb 16
Starting Weight: 96.8 Kg
Ending Weight: 94.0 Kg
Water Removed: 2.80 Kg
Start BP: 131/104 End BP: 110/78
06 Feb 16
Starting Weight: 96.4 Kg
Ending Weight: 94.1 Kg
Water Removed: 2.30 Kg
Start BP: 142/103 End BP: 118/102
09 Feb 16
Starting Weight: 97.7 Kg
Ending Weight: 93.9 Kg
Water Removed: 3.80 Kg
Start BP: 137/87 End BP: 107/70
11 Feb 16
Starting Weight: 96.4 Kg
Ending Weight: 94.0 Kg
Water Removed: 2.40 Kg
Start BP: 131/83 End BP: 99/59
13 Feb 16
Starting Weight: 96.9 Kg
Ending Weight: 94.2 Kg
Water Removed: 2.70 Kg
Start BP: 126/89 End BP: 177/129 (??)
16 Feb 16
Starting Weight: 97.4 Kg
Ending Weight: 94.2 Kg
Water Removed: 3.20 Kg
Start BP: 140/90 End BP: 120/68
18 Feb 16
Starting Weight: 97.3 Kg
Ending Weight: 94.0 Kg
Water Removed: 3.30 Kg
Start BP: 112/65 End BP: 119/96
20 Feb 16
Starting Weight: 97.4 Kg
Ending Weight: 95.5 Kg
Water Removed: 1.90 Kg
Start BP: 104/87 End BP: 96/74
23 Feb 16
Starting Weight: 98.9 Kg
Ending Weight: 96.0 Kg
Water Removed: 2.90 Kg
Start BP: 146/90 End BP: 110/65
25 Feb 16
Starting Weight: 98.8 Kg
Ending Weight: 95.3 Kg
Water Removed: 3.50 Kg
Start BP: 133/100 End BP: 144/81
**Start of NO ATENOLOL (beta blocker) on 26 Feb 16
27 Feb 16
Starting Weight: 99.4 Kg
Ending Weight: 95.7 Kg
Water Removed: 3.70 Kg
Start BP: 126/80 End BP: 94/64
01 Mar 16
Starting Weight: 98.7 Kg
Ending Weight: 94.8 Kg
Water Removed: 3.90 Kg
Start BP: 147/90 End BP: 94/67
03 Mar 16
Starting Weight: 97.3 Kg
Ending Weight: 95.1 Kg
Water Removed: 2.20 Kg
Start BP: 107/80 End BP: 120/81
05 Mar 16
Starting Weight: 97.5 Kg
Ending Weight: 94.9 Kg
Water Removed: 2.60 Kg
Start BP: 123/78 End BP: 100/71
08 Mar 16
Starting Weight: 98.5 Kg
Ending Weight: 95.1 Kg
Water Removed: 3.40 Kg
Start BP: 118/75 End BP: 157/71
10 Mar 16
Starting Weight: 98.2 Kg
Ending Weight: 95.6 Kg
Water Removed: 2.60 Kg
Start BP: 143/115 End BP: 103/65
12 Mar 16
Starting Weight: 98.1 Kg
Ending Weight: 95.7 Kg
Water Removed: 2.40 Kg
Start BP: 119/70 End BP: 96/58
15 Mar 16
Starting Weight: 98.6 Kg
Ending Weight: 95.4 Kg
Water Removed: 3.20 Kg
Start BP: 130/87 End BP: 124/52
17 Mar 16
Starting Weight: 97.2 Kg
Ending Weight: 95.5 Kg
Water Removed: 1.70 Kg
Start BP: 127/83 End BP: 96/81
19 Mar 16
Starting Weight: 99.0 Kg
Ending Weight: 95.6 Kg
Water Removed: 3.40 Kg
Start BP: 108/78 End BP: 121/88
22 Mar 16
Starting Weight: 99.1 Kg
Ending Weight: 96.3 Kg
Water Removed: 2.80 Kg
Start BP: 134/75 End BP: 102/75
24 Mar 16
Starting Weight: 99.2 Kg
Ending Weight: 96.3 Kg
Water Removed: 2.90 Kg
Start BP: 137/80 End BP: 99/72
26 Mar 16
Starting Weight: 99.5 Kg
Ending Weight: 96.2 Kg
Water Removed: 3.30 Kg
Start BP: 123/86 End BP: 114/84
**One month post-Atenolol (beta blocker)
28 Mar 16
Starting Weight: 99.5 Kg
Ending Weight: 96.6 Kg
Water Removed: 2.90 Kg
Start BP: 128/83 End BP: 106/74
As you look over the progression of the weights, you can clearly see the swings my BP took as time passed after dropping the Atenolol altogether. Only on the last few measurements do we see the starting BP to have any consistency. It took a while to achieve, but at least I found the right combination of Dry Weight and Blood Pressure in my post-Atenolol world.
Otherwise, I am doing well. My R arm feels good, and I can use it unrestricted. Next up...Removal of the Central line from my chest, which I will schedule early next week. With how well things have been going, what's after that...my transplant? (Let's hope so!)
That's all I have for now. My typing hand is exhausted and I'm beginning to make too many mistakes that must be corrected.
Have a terrific week, Everyone!
Good Health to All!
ScottW
**Update
I called my Vascular Surgeon's office yesterday to schedule the removal of the Central Line out of my chest. It will happen on Wednesday, 13 April. My dialysis clinic ordered special labs to support removal of the catheter, which I should have in a few days.
I will write up a report on the catheter removal a few days afterwards...hopefully with pictures!
SW
**Update
I called my Vascular Surgeon's office yesterday to schedule the removal of the Central Line out of my chest. It will happen on Wednesday, 13 April. My dialysis clinic ordered special labs to support removal of the catheter, which I should have in a few days.
I will write up a report on the catheter removal a few days afterwards...hopefully with pictures!
SW
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