25 May 2016

Okay, now that I have the whole multiple surgeries thing all typed up, it's now time to get caught up with everything else.

As described in my last post, the previous month has been anything but normal. Fortunately, you already have the abnormal, so let's get to the routine...

Dialysis Weights:

31 Mar 16

Starting Weight:  101.1 Kg

Ending Weight:  96.5 Kg
Water Removed:  4.60 Kg
Start BP:  130/90     End BP:  118/88

02 Apr 16
Starting Weight:  99.8 Kg
Ending Weight:  96.9 Kg
Water Removed:  2.90 Kg
Start BP:  112/81     End BP:  119/68

05 Apr 16
Starting Weight:  101.3 Kg
Ending Weight:  97.9 Kg
Water Removed:  3.40 Kg
Start BP:  174/108     End BP:  124/87

07 Apr 16
Starting Weight:  100.6 Kg
Ending Weight:  96.7 Kg
Water Removed:  3.90 Kg
Start BP:  156/115     End BP:  100/68

09 Apr 16
Starting Weight:  100.4 Kg
Ending Weight:  96.9 Kg
Water Removed:  3.50 Kg
Start BP:  134/82     End BP:  111/90

12 Apr 16
Starting Weight:  100.3 Kg
Ending Weight:  96.9 Kg
Water Removed:  3.40 Kg
Start BP:  137/89     End BP:  149/122

14 Apr 16
Starting Weight:  100.0 Kg
Ending Weight:  96.7 Kg
Water Removed:  3.30 Kg
Start BP:  130/76     End BP:  109/75

16 Apr 16
Starting Weight:  99.6 Kg
Ending Weight:  96.7 Kg
Water Removed:  2.90 Kg
Start BP:  128/91     End BP:  138/99

19 Apr 16
Starting Weight:  101.4 Kg
Ending Weight:  96.7 Kg
Water Removed:  4.70 Kg
Start BP:  150/91     End BP:  110/80

21 Apr 16
Starting Weight:  99.7 Kg
Ending Weight:  96.5 Kg
Water Removed:  3.20 Kg
Start BP:  139/86     End BP:  115/88

23 Apr 16
Starting Weight:  99.7 Kg
Ending Weight:  96.3 Kg
Water Removed:  3.40 Kg
Start BP:  113/77     End BP:  139/100

26 Apr 16
Starting Weight:  101.5 Kg
Ending Weight:  97.2 Kg
Water Removed:  4.30 Kg
Start BP:  164/104     End BP:  104/64

*28 Apr 16*
Starting Weight:  100.2 Kg
Ending Weight:  98.2 Kg
Water Removed:  2.00 Kg
Start BP:  122/33     End BP:  106/85
*Start of latest surgery phase

30 Apr 16
Starting Weight:  103.1 Kg
Ending Weight:  99.4 Kg
Water Removed:  3.70 Kg
Start BP:  154/96     End BP:  143/64

*I did not record the two extra dialysis sessions this week;
only the normal T/Th/Sa sessions.
03 May 16
Starting Weight:  101.0 Kg
Ending Weight:  98.4 Kg
Water Removed:  2.70 Kg
Start BP:  141/99     End BP:  112/72

05 May 16
Starting Weight:  102.5 Kg
Ending Weight:  99.6 Kg
Water Removed:  2.90 Kg
Start BP:    136/83     End BP:  125/87

07 May 16
Starting Weight:  103.6 Kg
Ending Weight:  100.3 Kg
Water Removed:  3.30 Kg
Start BP:  173/107     End BP:  132/64

10 May 16
Starting Weight:  103.6 Kg
Ending Weight:  99.9 Kg
Water Removed:  3.70 Kg
Start BP:  150/87     End BP:  106/69

12 May 16
Starting Weight:  102.3 Kg
Ending Weight:  99.6 Kg
Water Removed:  2.70 Kg
Start BP:  163/91     End BP:  136/85

14 May 16
Starting Weight:  102.5 Kg
Ending Weight:  99.8 Kg
Water Removed:  2.70 Kg
Start BP:  161/98     End BP:  136/94

17 May 16
Starting Weight:  103.8 Kg
Ending Weight:  100.2 Kg
Water Removed:  3.60 Kg
Start BP:  155/109     End BP:  118/76

19 May 16
Starting Weight:  102.6 Kg
Ending Weight:  99.7 Kg
Water Removed:  2.50 Kg
Start BP:  161/101     End BP:  119/92

21 May 16
Starting Weight:  102.6 Kg
Ending Weight:  99.6 Kg
Water Removed:  3.00 Kg
Start BP:  158/97     End BP:  128/79

24 May 16
Starting Weight:  103.3 Kg
Ending Weight:  99.8 Kg
Water Removed:  3.50 Kg
Start BP:  163/100     End BP:  113/73

The new dry weight of 99.5 Kg is evident. However, the goal of keeping my post-D weight above 110 systoloic is happening every treatment (Tx). I am still waffling about about the dry weight, and may even decrease it by a half kilo just to see what happens. We'll see...


May 2016 Labs:
(Again, due to the April/early May surgeries, I am skipping the April 2016 Labs)

*Albumin (17 May): 3.80 g/dL     (-0.30 from 22 Mar)
  (A measure of Protein in the blood)     NR (Normal Range) 4.0 g/dL or Higher

*Hemoglobin (17 May): 9.9 G/dL    (-1.00 from 22 Mar)
  (A Measure of Anemia)

*Ca Corrected (03 May): 9.90 mg/dL     (+0.10mg/dL from 02 Mar)
  (A measure of Heart and Bone health)     NR 8.40 to 10.20 mg/dL

*Phosphorous (07 May):  4.30 mg/dL    (-0.20 mg/dL from 12 Mar)
  (High Phosphorous affects the health of your Heart and Bones)     NR 3.0 to 5.5 mg/dL

*PTH Intact (17 May):  222 pg/mL     (-171 pg/mL 22 Mar)
  (A measure of Vitamin D absorption and bone and tissue health)     NR 150 to 600 pg/mL

*K+ (17 May):  5.4 mEq/L    (-0.1 mEq/L from 22 Mar)
  (Proper potassium levels keep your nerves and muscles working well)     NR 3.5 to 5.5 mEq/L

*spKdt/V Dialysis (03 May):  1.48     (-0.13 from 08 Mar)
  (A measure of the effectiveness of dialysis and blood filtering.)     NR 1.20 or Higher  

I don't know what else to catch up on because of everything I wrote about the multiple surgeries, extra dialysis sessions, etc. Let's see...

Because of the surgeries my sleep is all out of whack...again. I get anywhere from 2-11 hours at any given time, and will often nap off and on even when I've had lots of sleep over a twenty four hour period. Even my Post-D naps are furtive, at best. As times gets on past they surgeries, I'm confident the sleep will get turned around.

My appetite is also off...badly. However, the surgeries again will wreak havoc on anyone's appetite. This too will get turned around; though it might take a bit longer than normal.

My headaches have stayed consistent over the past two months, as has my use of T3's to combat them. I am so happy that I finally have an effective means to fight these nasty TMD headaches. I spent over 15 years dealing with those migraine-like headaches with no effective means to tamp them down. Talk about miserable...

My energy level has also been greatly reduced because of the surgeries. At three weeks post-surgery, I am finally seeing my energy uptick. In a few more weeks, I expect to be back to normal...well, as normal as my kidney-less, dialysis addled body can be!  :o)

Ever since the surgeries my feet have been ablaze with the neuropathy. I am burning through a twenty pound bag of ice every three days fighting to get the burning under control. Every time I think I've done it, the neuropathy ramps up again and I am thrusting both feet back into an ice water bath. It has gotten better, and I will keep up my efforts to get it under control again.

...Wow! those surgeries really screwed up a lot of things!

I think that's about it for today. If I think of anything else, I'll add it on to the end of this one.

The journey continues... Thanks for staying with me!

Good Health to All!

ScottW

23 May 2016: Surgery Update

As you all know, I had my chest tube excised on 13 April of this year. Exactly 15 days following that, I learned on 28 April that my Artificial Graft was closed. I was at dialysis--trying to be put on Tx-- when this little revelation was given by the staff nurse. They immediately sent me over to the hospital (literally across the street) to have Interventional Radiology attempt to unclog the graft.
On my way to Radiology I actually saw my Vascular Surgeon in the hallway. He later told me that when he saw me there he thought to himself, "Hmm. This can't be good." He also to me to call his office if needed.
Well, I was about to do the procedure when the Radiology physician learned that I was allergic top the contrast dye and immediately cancelled the attempt as they were not equipped to deal with this contingency.
By this time my wife was with me and took me over to the office of my Vascular Surgeon. I saw him, again, in short order, and he sent me back to Day Surgery so we could unclog the graft.
The whole check-in and pre-surgery thing was hectic as I was needing dialysis. The chaos around me reminded me of my paramedic days. The best way to describe the madness is "Organized Chaos." Just like a major trauma call, or an ER scene when a severe trauma case comes in and every is chaotically doing their jobs, talking over each other, instructions given, IV's inserted, blood drawn, patient prepped for surgery amidst everything...
So, within ten minutes of checking in, I was ready for surgery. Unfortunately (once again), the whole contrast dye allergy thing came up and forced my surgeon to only insert another chest catheter so I could get my dialysis treatment that day; which I did once released from the hospital. I was scheduled to do the graft thing on Monday, 02 May. In the meantime, I had my usual Saturday dialysis session, then ran a short course of Prednisone (a Parabolic steroid generally used as an anti-inflammatory) on Sunday night and early Monday.
Once Monday arrived my wife and I showed up at Day Surgery again ready to do the graft procedure. We were ready and waiting in the pre-surgery when I was told that my Potassium level was far to high. Apparently, I had a nasty spike in my K+ and was charted at 7.70--2.50 over the top end of the acceptable level. So, the surgery was off. Instead I was admitted to the hospital so I could do a session of in-house dialysis using the K1 solution (to draw out additional potassium).
In the middle of everything that day, the entire hospital was going through the pains of a new paperless system that was implemented that day...which we already knew was happening, so we were expecting things to be slow. Everyone, nurses, techs, doctors, etc were all bogged down trying to input orders on the new system. It took over two hours just to get admitted to the hospital! Anyhow, the dialysis commenced with zero issues. I then had to be released from the hospital, which took another hour plus.
The next day was my normal Tuesday dialysis--again using the K1 solution--and later that evening, another course of Prednisone ahead of the surgery.
On Wednesday, 04 May, I was again at Pre-Op ready to have the graft worked on. My potassium was taken, and it had fallen to a terrific 4.6.  Once I awoke from surgery, the Vascular Surgeon stated that things didn't go as planned. The Arterial side of the graft cleaned up nicely, but the venous side did not. He had to detach the venous side and replace it with a new tube that was also moved to just beside my elbow. This meant three new incisions on my arm instead of just one, and a longer healing time. Also, he had to use a small amount of contrast dye, so I had to do dialysis for the third day in a row to avoid any potential anaphylactic reactions from the contrast dye. That was fun.
Then on Thursday, I again had my regular dialysis treatment (Tx) making it four sessions in a row! Other than my ridiculously numerous dialysis sessions, I spent my time recovering from the surgery.
The following Wednesday,11 May, I met with my Vascular Surgeon for a post-op follow-up. Everything was great at that time. The bruit was excellent and the surgical sites looked healthy and free from any infections of irritations. Although still swollen (from the surgery) and still bruised, the arm is in great shape. 
In the days since that appointment, I continue to recover. My arm is much better, but I still cannot lift more that about 5 pounds, and only for short periods. Anything more or longer and my arm weakens, starts to ache, and then turns painful. A few more weeks should see my arm stronger, with no swelling and decreased bruising.
So, hopefully around mid-June I will begin using the Artificial Graft once again. A week or two later I will have the chest tube pulled...again. I did learn a terrific bit of info to help the graft, which is that a slightly hypertensive patient has an easier time keeping the artificial graft open. So, I immediately increased my dry weight (currently at 99.5 Kg's--an increase of 6.0 Kg's!)
My body hasn't really enjoyed the much higher weight, but so far, I have no fluid in my lungs, no obvious swelling in my legs, arms or torso. My BP has stayed above 110 Systolic following each dialysis session, which is the minimum I need to attain to keep the graft flowing.
And there you have it...the latest in the long saga that the Phoenix trip has devolved into. If this graft fails, I am seriously considering just staying with the Central Line until I have my transplant. Especially when considering that my transplant is very likely to happen between this Fall and the end of the year.

What fun this has all been!

I will catch up with my regular blog in a few days, so be looking for that as well.

Until then...

Good Health to All!

ScottW

06 May 2016

I have much to discuss, but cannot do much typing right now due to needing ANOTHER surgery on my arm this past Wednesday.
I will update the blog when I am able to type lots more without hurting my arm.

Until then, Good Health to All!

ScottW