Post-Transplant Update: 20 February 2018

Some terrific news was received last week that was a long time coming...

I had my [now] monthly Kidney Clinic visit last Wednesday morning (14 Feb). My weight was good at 112.2 Kg, my vitals were all in line, and the clinic pharmacist was pleased with my current meds, my schedule for taking meds and how I am tolerating all of my meds. Here is my current list of meds:

Anti-rejection Meds

*Tacrolimus (Prograf): 1 mg 2x/day

*Prednisone: 5 Mg 1x/day

*Mycophenalate (Celcept): 250 mg 2x/day

Heart Meds

*Isosorbide: 20 Mg 2x/day

*Hydralazine HCL: 25 Mg 3x/day

*Atorvastatin: 20 mg 1x/day (at bedtime)

*Aspirin: 81 mg 1x/day

Misc

*1-A-Day Men's Vitamin: 1x/day

   *I have to take the non-50 Years+ version as that one contains Iodine, which I am allergic to, internally.

I also will be changing the Celcept to a comparable med called Myfortic because of my inability to tolerate higher doses of Celcept, which cause me a lot of diarrhea.

The Myfortic should not have any appreciable side-effects, but carry the additional benefit of my being able to lower my daily Prograf dosage. This is important because a significant side effect of Prograf is hand tremors. The lower my Prograf intake, the less my hands shake.

I should be starting the Myfortic in the next week or two. Of course, I will let you know how the new med goes...

As I grow stronger, some of these meds will be adjusted a/o eliminated; depending on how I am doing. Other meds may also come into play in the future as my health dictates.

After the Pharmacist visited, my main clinic doctor--and the Kidney Clinic's Medical Director--came in. He was very pleased with my progress! My vitals are looking wonderful, my weight has increased proportionally, my kidney is performing beyond expectations (FINALLY!), my heart is in excellent shape and I am finally healing properly from both surgeries [this year], which means I can now begin lite exercising which will further my overall progress.

(And here's the terrific news I referred to at the beginning of this post...)

So, because things are doing better and better, my doctor has released me from the Kidney Clinic's care to that of my local nephrologist! 

Normally, this would happen between 1-3 months post-transplant; but because of everything I've had to deal with since the transplant, I took a full 9+ months to get that clearance!

My next visit with the clinic is around the anniversary date of my transplant, and about every year thereafter.

Now, getting that clearance does not mean I am finished with other doctor visits--besides Nephrology. From now on, I must have regular follow-up visits (and a few new doctor visits) from  Cardiology (obvious reasons), Oncology (check for potential cancer development), Dermatology (check for skin cancer), Radiology (Renal biopsies, renal artery check etc.) Neurology (look for deficits), Gastroenterology (colonoscopies), Immunology (immune system health), Primary Care (general care) and Dental (oral health and free of germs). These appointments will happen every six months, or so, depending on physician instructions. Collectively, all of these various medical disciplines will help ensure my best health possible.

In addition, I must get a flu shot every year from now on so that I avoid any influenza virus from attacking my new kidney. Boosters needed for pneumonia, hepatitis, etc will be determined by my nephrologist.

In other good news...

Over this past week, my appetite has been good, the nausea decreased, I am sleeping decently and my urine output has been consistent. Overall, I am doing and feeling much better. I finally feel like I am on the upswing.

My next labs will be drawn tomorrow (21 Feb), and I will post the results here as an addition to the end of this post.

So, there you have my fantastic news! 

I hope that you have an excellent day, no matter your circumstances! 

Good Health to All!

ScottW

22 Feb 18
**This update is later than I expected because all these most recent lab results did not get posted until this afternoon. The +/- represents comparison vs two weeks ago.

*Tac:   6.7  (No Change--NC)  In current target range (6-8).
*Creat:   1.56  (-0.02) In Range--I.R.

*CA:  10.1  (NC)  I.R.
*RBC's:   4.2  (+0.09)  Low
*WBC's:   7.4  (+0.3)  I.R.
*HCT:   37.4  (+1.1)  Low, but improving steadily
*Lymph:   11.8  (+1.2) Low
*Lymph ABS:   0.9  (+0.1)  Low
*Neut:   71.2  (-3.2)  I.R.
*Neut ABS:   5.5 (NC)  I.R.
*GFR:   49  (NC) High
*BUN:   29  (+5)  High
*Gluc:   95  I.R
*Phos:   3.7  (+0.8)  I.R.
*Hemo:   11.9  (+0.3)  Low
*K+:   4.4  (-0.1)  I.R.
*NA+:   138  (-3)  I.R.
*BK Virus:  NOT Detected
*CMV:  NOT Detected

The majority of these results are either in line, or getting there. As I've stated before, surgery messes up your lab results, and it takes time to get your numbers back to where they need to be. Mine are coming along very nicely!

**The BK Virus and CMV checks are done once each month (post-transplant, of course!) to examine the presence of either of these viruses. Having one or both in your transplanted organ can kill the organ, and endanger the patient's life. I will explain both of these issues in my next blog.