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