Post-Transplant Update 27 March 2018

A quick note only this morning as I do not know if I'll be able to get to a longer update any time soon...

Last week I told you about my Creatinine jumping from 1.64 to 1.92, and that another lab draw was ordered to check on whether or not the reading was an aberrancy. This morning, I did the follow-up labs and the Creatinine came back with a huge jump of 0.79 to 2.71! This is hospitalization territory.

Plus, my Lymphocytes took a nosedive from 11.5 down to 7.9, and the Lymph ABS fell 0.6 to 0.2. Additionally, my Neutrophils jumped 1.6, the GFR is now low, the BUN is jumped to double the top end of the range and my RBC number fell.

While the med Myfortic will need to be either changed or adjusted, we may also need to look at the renal artery, and other things as well.

...

I just now received the call from the Transplant Committee to be admitted to the hospital!

I will update you as soon as I am able.

Until then...

I've gotta go!

ScottW

Post-Transplant Update: 22 March 2018

Things have been going well.  

Let's start with my latest lab results...

(20 Mar 18)

Tac:   7.1  (-0.3)  IR

Creat: 1.92  (+0.28)  High  

CA:   10.4  (+0.3)  IR

RBC:   4.4  (NC)  Low

WBC:   6.7  (+0.2)  IR

HCT:   39.7  (NC)  Low

Lymph:   11.5  (+0.5)  Low

Lymph ABS:   0.8  (+0.1)  Low

Neut:   69.5  (NC)  IR

Neut ABS:   4.6  (-0.1)  IR

GFR:   38  (-8)  Low

BUN:   35  (+7)  High

Gluc:   94  IR

Phos:   3.9  (+0.4)  IR

Hemo:   12.8  (+0.2)  Low

K+:   4.3  (-0.4)  IR

NA+:   139  (-1)  IR

BK: Negative

CMV: Negative

*IR = In Range    *+/- = over/under from last labs   *Low/High = compared to current value ranges  
*NC = No Change 

The jump in my creatinine is troubling, but my Tac is excellent; so there is little worry about any rejection. I have been instructed to keep the Myfortic (Celcept) dosage the same for now, and do labs again next week in order to check if the creatinine reading was aberrant or truly off. If the number is indeed higher, then we'll address the problem with a medication adjustment.  Overall, I am pleased with these latest results.

I had my first visit with a non-Kidney Clinic doctor last week. The appointment took nearly an hour as we discussed everything that has taken place since my transplant. He was pleased with my progress considering all the setbacks I've had in the last ten months.

My next appointment will be in early April.

As I'd spoken of in my last entry, I have finally started wearing shoes whenever I go walking (but still NOT wearing socks around the house). It is really weird to wear shoes again, and I actually tripped over my feet a few times on the first walk!  No falls resulted, though, and my walks have concluded successfully. Once I get home however, I get those shoes and socks off as quickly as possible! My feet are burning like mad and getting everything off of them is paramount (!).

On the plus side, my walks have increased from a few hundred yards to nearly a mile! Granted, the walks aren't the swiftest I have ever done, and going up even short, slight inclines is exhausting... at least I am putting in the effort. My goal with walking is to be matching my previous pace--from before I was sick--of eight miles in one hour. I will try to get back to that physical shape and stamina by the end of the summer. Considering where I am now, that goal may be lofty, but I know that I can accomplish this. My progress towards this goal will be documented. For now, I am walking every other day and giving my body time to rest between walks. This allows not only rest, but the natural building of muscle, as well.To be up to a mile in such a brief period of time is surprising.  I love muscle memory!  :o)

My appetite remains good, though I am attempting to keep my food intake down a bit until I get more active as my weight has increased too much over the past month and a half from ongoing inactivity brought on by the much longer than expected post-surgical healing. For me, eating like this becomes a balancing act because throughout my entire life, if I fail to get enough to eat during the day--and at regular intervals, I get extremely nauseated for some reason. I think that I have previously explained that my body mimics hypoglycemia without my being hypoglycemic. I know...I've been tested several times for any indicator of hypoglycemia a/o diabetes. The result is always the same...no indication of either.    So anyway, finding that proper balance between eating enough and too little is tough. Some days I do well, and others not so much. 

My abdomen has been healing nicely. The pain from the intercostal muscles seems to be gone, and I am going longer and longer without the binder on. I even drove myself on errands twice yesterday without the binder on, and I was no worse for wear. That is a significant improvement! I still get lots of pain when I do too much, but I am seeing definite progress in my healing. The only ongoing thing with my abdomen is continued numbness of the entire upper and lower abdomen. I presume this will decrease over time.

Quality sleep continues to be a challenge for me. I have been regularly getting between 7-8 hours of sleep every night, but find myself exhausted most days. I think this is because of the healing my body is doing. What I am hoping for is that the more I heal, the better I will sleep. We'll see.

The headaches have been up and down in both intensity and duration. I have still to begin those relaxation techniques I spoke of on my last entry, but I will get those started.

I have been attempting to kick start my brain again by doing jigsaw puzzles of at least 1,000 pieces. This helps me to recognize patterns, details, logic etc, and has really sharpened my brain processes. I have already completed two puzzles and am working on a third. I am well on my way back to great mental acuity. In addition, I still play games of logic, trivia, strategy, etc, and have actually started reading history books once again. My current reading is entitled, "The Washington Hypothesis" by Timothy Ballard. It is a fascinating read that contains much history that has been lost to secular historical revisionism, and I personally find it to be incredible history. I highly recommend it to anyone who loves United States history!

That's all I have for today. I am looking forward to accelerated healing and overall progress over the next few weeks.

Until next time...

Good Health to All!

ScottW

Post-Transplant Update: 07 March 2018

I started the Myfortic on Thursday of last week, and things are going well, so far.

If you'll recall, the Myfortic is a substitute for the Celcept, an immunosuppressant. The benefit is that it is more tolerable [for me] at higher doses than the Celcept. The reason for this is that Myfortic is absorbed lower down the Small Bowel than the Celcept, which results in fewer incidents of diarrhea. If I continue to tolerate the Myfortic, the next step is to reduce the Prograf (Tacrolimus) lower, as my blood work indicates.

(From WebMD)

def: "Myfortic (Mycophenalic Acid) is used in combination with other medications to keep your body from attacking and rejecting your transplanted kidney. It belongs to a class of medications called immunosuppressants. It works by weakening your body's defense system (immune system) to help your body accept the new kidney as if it were your own."

My current dosage is 320 mg 2x/day. This level may change depending on how well I continue to tolerate the med. I will update you of any changes...

Everything else continues to be on the upswing. I am going most days at home without the aid of the abdominal binder in order to further the healing and strengthening of the abdominal way. I do pretty well during the day, but by the evening, I am getting very sore, and start hobbling around. 
Whenever I go out and about I still use the binder as road travel and all its bumps, accelerations and decelerations, road vibrations etc. are actually pretty hard on a healing body. Until the pain that accompanies road travel decreases, I will continue using the binder.
In either case, the abdominal strengthening improves day after day, and the pain I have should continue to decrease until I no longer need the binder at all. Just how long that will take is an unknown; but I am seeing improvement day after day...incrementally thought is may be.

I do not recall if I had stated previously, but my feet are getting better; albeit slowly. I can now leave my feet under the covers at night. Granted, my feet still hurt, but not so badly that they are intolerable. With the Spring coming on, I am going to start wearing socks around the house [this week] in order to try to get my feet used to wearing them on a regular basis again. IF I can get my feet used to them without having to suddenly remove my socks from heat a/o pain, then I will start on shoes for short periods of time. After about four years of not wearing shoes (other than Teva sandals), I'm getting a bit impatient to get my feet better so that I can start getting some walking in as it is not only great for my healing, but is a great way to increase my cardiovascular health. I will keep you informed on this front, as well.

Latest Labs:

(07 March 2018)

Tac:   7.4  (+0.7)  IR

Creat: 1.64  (+0.08)  IR  

CA:   10.1  (NC)  IR

RBC:   4.4  (+0.2)  Low

WBC:   6.5  (-1.2)  IR

HCT:   39.7  (+2.3)  Low

Lymph:   11.0  (-0.8)  Low

Lymph ABS:   0.7  (-0.2)  Low

Neut:   69.5  (-1.7)  IR

Neut ABS:   4.5  (-1.0)  IR

GFR:   46  (-3)  IR

BUN:   29  (NC)  High

Gluc:   110  High

Phos:   3.5  (-0.2)  IR

Hemo:   12.6  (+0.7)  Low

K+:   4.7  (+0.3)  IR

NA+:   140  (+2)  IR

BK: Not Taken

CMV: Not Taken

*IR = In Range    *+/- = over/under from last labs   *Low/High = compared to current value ranges  
*NC = No Change 

All in all, my labs look good. The Tac remains in our current range target, the Red Blood Cells are now just 0.1 from being at the low end of the normal range, which hasn't happened since the onset of the kidney disease over eight years ago.  My Hematocrit has been consistently rising since the hernia repair, and is nearing normal range, as well.
The Lymphocytes (and ABS) are still bouncing around, which is no surprise. 
So, no complaints whatsoever!

My headaches continue--quite unsurprisingly, I might add--to be an issue. However, most days they are now manageable with just two Excedrin, or the Excedrin plus one T3. I still wear my mouth guards (NTI devices) more in an effort to curb the bruxism I unconsciously create when I sleep [which causes the TMD Headaches]. Overall, I am pleased with my progress on the headaches. In the next while I will begin the numerous relaxation and body awareness techniques that will further aid in ridding me of the constant headaches.

Sleeping continues to be hit or miss. To be fair, much of the issues revolve around getting up frequently to drain my bladder. Some nights I only get up two or three times over eight hours; while most nights I arise every 1.5 hours. If I am particularly tired, once in a while I can get back to sleep without getting up; but this is rare. As I still measure my nightly output, I am ridding my body of between 1.5-2.0 Liters each night. This high volume of urinary excretion will eventually even out with the rest of the day, according to my doctor at the Kidney Clinic. My new kidney, the bladder and my body in general are still learning/re-learning that whole annoying urination thing singularly and as a team, so to speak. It will just take time.
And on this whole subject, my urine color goes anywhere from concentrated darker yellow to barely colored. I typically have more colored urine during the daytime, and far clearer at night; though, I have experienced the opposite and a mix of both throughout any given day. Again, and depending on my fluid intake, this should even out in the long run as all organs and systems integrate properly.

Lastly, I have my first post-Transplant appointment with my local nephrologist next Thursday (15 March). As always, I will, of course, write about that afterwards.

So, until next week...

Good Health to All!

ScottW