Post-Transplant Update: 24 January 2018

That cardiology visit I had right after my last post went extremely well! The doctor is very pleased with my vitals, as well as how I am doing overall. He has no further tests at this time, and I will continue to use the heart meds on the same dosages for at least the next few months. My next cardiology appointment isn't until June!

My healing continues to be slow. Though I am off most of the pain meds, it is not because the pain has dissipated, but because I decided to wean myself off of them. Now, I only take those meds if I am hurting a whole lot.  I often push myself too much and end up with a lot of pain, but I am trying to minimize that day by day. Along the pain med lines, I have had zero withdrawal effects because I did a slow draw-down on the meds which allowed my body to adjust to diminishing meds without the awful effects of going cold turkey; which I had to do following my back surgery in 2000. That was a terrible 24 hours of ridding the narcotics from my body. I'm talking the full blown symptoms of cold turkey withdrawal...chills, fever, excessive diaphoresis, vomiting, diarrhea, complete exhaustion. And I was only on heavy meds for a month back then! I certainly don't want to repeat that episode...  :o(

I think I stated in my last blog that I was going a bit of time without by abdominal binder both during the day and at night. Unfortunately, I had to once again wear the binder 24/7 after sneezing several times one day, causing me to tweak something that caused extra pain. In addition, my sides still hurt (the intercostal gap muscles), as does my lower abdomen. Plus, a small area just R of the incision and near the now indistinguishable belly button, has a lot of pain. It doesn't help that I have been sneezing frequently this month. 

*On an aside, I don't know if I ever mentioned that when I sneeze, I usually do it just one, powerful time, then I'm done. This causes my entire abdomen to tense, tighten and seize up, which is what causes so much pain. OWW!!

So anyhow, I am wearing the binder both when awake, and while sleeping. This helps my muscles to be a bit more relaxed. Then there's the fact that I continue to sleep in a supine position, and most on my sides. Doing this still causes me pain, but not so much that I can't sleep.

The neuropathy in my feet is getting better....very, Very, VERY slowly. With winter here, the cold weather helps to keep the burning down, but I still have to soak them in an ice bath. Those ice baths are no longer nasty cold, though. Ever since the transplant, and my feet losing so much water volume, I can no longer bring my feet to the point of cold injury. I must now use only a handful of ice; otherwise my feet become painful from the cold within a minute or two.

On my last visit to the weekly Kidney Clinic, I was instructed that I am doing well enough to cut my lab draws to once per week. IF my labs are good for two consecutive weeks without any med changes/adjustments, then I could reduce those lab draws to once every two weeks. Well, today was my second lab draw, and my numbers are looking terrific! 

The Tac reading is at 6.5 (excellent!), my creatinine is fantastic and the rest of my numbers are nearly back in line.
My latest labs values:

*Tac-- 6.5 (Normal Range)
*Creat-- 1.61 (-.02)
*CA-- 10 (NR)
*RBC's-- 4.05 (-.03)
*WBC's-- 7.3 (NR)
*HCT--35.7 (No Change)
*Lymph-- 11.7 (-0.8)
*Lymph ABS-- 0.9 (-0.1)
*Neut-- 71.8 (-1.5)
*Neut ABS-- 5.2 (NR)
*GFR-- 47 (No Change)
*BUN-- 26 (+2)
*Gluc-- 100 (NR)
*Phos-- 3.2 (NR)
*Hemo-- 11.4 (No Change)
*K+-- 4.2 (NR)

Speaking of Kidney Clinic, I am finally doing well enough that I am now going just once per month! A couple more months of doing well and I might be allowed to go for two months between visits.

I think I'll stop there for today.

Great overall progress; the kidney continues to work well and my med schedule is finally stable! I'll take all of that!

So then,...until next week...

Good Health to All!

ScottW

P.s  This weeks' lab draw was my second of once-per-week-draws. With my numbers being great I was given authorization [this morning, 26 Jan] that allows me to now do labs just once every two weeks! YAY!!!

*However, we are trying to get a replacement med for the Cellcept called Myfortic. If we can get the OK from insurance, I will have to go back to once every week draws to properly monitor the effects the new med will have on me. This reversal in the lab draw schedule would only be temporary.
On the positive side, Myfortic should be a med that my body can better tolerate. This means that with I can take a higher dose of this med, and reduce the Prograf so that I have less of a chance of getting skin cancer (a side effect of anti-rejection meds), and the hand tremors caused by the Prograf will be further diminished. Both changes would be very welcome!

Post-Transplant Update: 04 January 2018

I know that it has been more than a few days since my first entry about the hernia surgery, but with Christmas and New Years, plus my continued pain from the surgery, it really is understandable that I am just now getting to finish up with that surgery.
So, let's get that wrapped up...

Getting home from the hospital was no picnic. Having to sit in a car for 45 miles with intense abdominal pain is not exactly my idea of a good time. But, we do what we must. Getting up the stairs at home was a slow, painful and laborious process; but once I was at the top of those twenty stairs, I could lay down and just be still...aahhh!

For the first two weeks at home I was on pain meds pretty much 24/7. Between the new scars and the muscle cuts on both sides, any movement at all remained intensely painful, no matter what I did. I had to have help standing, sitting, laying, etc.

For the first month I was forbidden from bending more that 45 degrees, could not pick up anything over two pounds, could no climb or descend stairs alone, or sit up straight for more than a few hours.

Much like my back injury, you do not realize just how many muscles you use for moving your arms, turning your head, lifting your legs, etc. This surgery reminded me just how easy it is to trigger lots of pain...and a thing I did NOT miss from that back surgery in 2000.

That first month, my wife did all the cooking...frightening, to be sure!  :o) ...cleaning, getting whatever I needed, helping me to sit, get in bed, get to the restroom, get dressed, helping me to shower so I didn't fall etc. In addition, I still had to get my blood drawn twice each week for labs, and go to follow-up appointments and kidney clinic.

Two weeks after arriving home I saw the surgeon to have about half of the staples removed, then the other half two weeks later. While the scar has a lot of healing still to do, it is looking less inflamed, and is mostly closed at this point, with the exception of one small area on the lower abdomen that is about an inch long. I am currently putting antibiotic cream on that spot, and covering it with clean gauze twice each day. It is slowly improving.

By mid-December I found that I was a long way from being where I had hoped to be in my healing. I was still in a lot of pain both mid-line and on both sides. It is slowly getting better, but as of right now, I am about a month behind in my healing. I believe this is the case because the hernia repair was my second major surgery in six months and my body is just simply exhausted and unable to bounce back as quickly as I usually do. The doctors and techs I have discussed this with have all agreed that my recovery is just going to take longer that normal, and that I must be patient.

Ever since the surgery I have been sleeping in a semi-recumbent position because this is most comfortable. About a week ago I began sleeping on my side a few hours every few nights....it feels so good, too! However, I am still doing most of my sleeping and napping in that semi-recumbent position. 

My day to day activities have begun to increase a bit. I have started doing some cooking again, getting my laundry done, and even putting in a little work at my computer. I can now walk up and down stairs unassisted, but not unaccompanied. I can walk further now--about 50-150 yards at a time--but wear out quickly, and my pain ramps up quickly, as well. I am going on walks about five times each week (accompanied by my wife, of course), and feel a bit stronger each time I go. Again, improvement is drearily slow, but I am feeling stronger despite the pain.

Speaking of pain, I started voluntarily decreasing my pain meds around two plus weeks ago. Overall, my use of the meds has decreased about 55-60%. At this rate I expect to be off the meds by mid month, or so. It doesn't help my pain level when I have an ultrasound on my kidney and renal artery, like I did yesterday. It was a normal follow-up exam that every transplant patient must do around the six month post-transplant mark.

Unfortunately, the tech pushing on my new scar for twenty minutes made me feel like I just got out of the hospital again! I know the increase in pain is only temporary, but it really hurts!  :o(

Next week I have another follow-up with my Team Cardiologist. I will let you know how that goes.

Oh...I nearly forgot...

With the hernia near by bladder repaired, I am finally able to properly process fluids, and as a result, I have lost 13 Kg's of water weight that had accumulated since my rejection episode in September. The water weight quite literally dropped by 1.5 Kg's per day for a little over a week.

I left the hospital in November at just over 121 Kg's. Today, I weigh 108 Kg's! Not exactly a preferred weight-loss method, but I am sure glad that weight came off exactly as I expected!

And, I believe that I am now caught up. If you have any questions regarding anything about my surgery and recovery, please leave a comment for me, and I will address that as soon as I can.

Until next time, the...

Good Health to All!

ScottW