Post-Transplant Update: 21 October 2018

I am late getting this update written simply because I was finishing unpacking from the move, and recovering from a much greater than normal daily activity level. 

It has been good for me; doing this move. Though exhausting, the constant activity has helped kick start my body a little, and I am getting through each day with more energy than I have over the past year. This is definitely a good thing!

I forgot to mention in my last post that I had my scheduled Belatacept infusion on October 2nd. Once again, there were very few appreciable side effects.

Unfortunately, both my weight and my BP have been trending upward over the past two weeks. As of this morning, my weight stood at 119.1 KG (up from 117.1 KG four days ago). As far as my blood pressures, the A.M reading has elevated from the mid-110's (Diastolic) to mid-120's, and I am now struggling to have the readings be in the high 120's to low 140's.

The P.M. readings are worse...much worse. Previously these ranged from the 120's (Diastolic) to the low 130's. Now, I am struggling to get readings lower than the high 140's.

Despite these BP readings, my pulses have been fairly consistent; ranging from the low 60's to the mid 70's. Not bad.

Now, I have seen this BP trend before and, not knowing what I was seeing, I ended up in the hospital last Fall for what was assumed to be a rejection. Instead, it was the occluded renal artery. After the artery was opened, the doctors told me that it might need re-opening every once in a while. Last Spring during my full rejection episode, a follow-up renal Angiogram showed a 15% occlusion of the artery. As of now, this recent BP trend is looking exactly like last years' and I am going to cut it off before things become acute.

I have my next Kidney Clinic appointment on the 30th. I will keep a close eye on the BP until then. IF things suddenly spike extremely high, I will call the clinic immediately. If they maintain as they are now, I will wait. In either event, I anticipate a possible Renal Ultrasound as well as a Renal Angiogram with balloon expansion of the renal artery. I will definitely keep you updated on this one!

Now, on to the latest labs...

16 Oct 18 Labs:

*Creat:   2.37 (+0.03) Final average yet to be found.

*HCT:   34.2 (+5.4) Low

*Hemo:   10.4 (+1.4) IR

*Lymph:   8.4 (-6.1) Very Low

*Lymph ABS:   0.6 (+0.2) Very Low

*Neut:   79.1 (+12.4) Extremely High

*Neut ABS:   5.3 (+3.5) IR

*RBC:   3.72 (+0.56) Very Low

*WBC:   6.7 (+3.9) IR

*BUN:   34 (NC) Very High

*CA:   10.1 (+0.5) IR

*GFR:   30 (NC) Extremely Low

*Gluc:   101

*K+:   4.6 (+0.1) IR

*NA+:   140 (NC) IR

*Prot:   7.1 (+0.5) IR

*MG:   2.6 (+0.5) IR

*BK:   Not Checked

*CMV:   Not Detected

     NC= No Change     IR= In Range

Once again I am highlighting the Hematocrit, Hemoglobin and Red Blood Cells in a follow-up to the Aranesp shot I had earlier in the month. All these numbers rose as they should have. Though still on the HCT and RBC, the rebound was nice to see; especially considering I received only a single blood booster.
Also, the White Blood Count came back nicely from two weeks ago. It had been in dangerous territory, so rising as it did makes my brain relax a lot.
Lastly, the Lymphocytes did exactly as I anticipated and dropped hugely after yet another significant rise. Seeing that I am now over six months post-rejection, this number should soon begin to settle into a normal range...should. As always, time will tell.

I don't recall if I mentioned this, but my wife and I are scheduled to go on a seven day Western Caribbean cruise in late-December. Because of this, I am trying every day to become more active in order to build as much stamina as I can over the next two+ months. I want to be able to enjoy the cruise as much as possible, and to do that I need strength and the ability to walk more than a couple of hundred yards. 

Next, the TMD headaches. Let's see...the best way to put this is probably ever-present, never-ending. I have not had any sort of a break in the headaches at all this month. No matter how much I work on it, he jaw has become so stressed that it just isn't releasing the tension. For the most part I have been able to keep the headaches from exploding into unmanageable territory...keeping them in merely painful. At least I have been able to achieve that much. A small victory on the TMD front is a victory nonetheless.

My next Belatacept infusion is also on the 30th of this month. Assuming the Kidney Clinic does not hold me over for any renal tests, the infusion will proceed as planned. On the other hand, if the clinic orders tests, I actually have a three day window in which to have the infusion. In that case, I will call to reschedule the Belatacept immediately.

In other news, the abdominal numbness I've had since the hernia repair last November has been slowly receding. I am starting to feel tenderness over my lower abdomen for the first time. This is not pain per se, buy just a tenderness to pressure on the skin and irritation from anything rubbing the skin. I will often forget to not lean against something with my lower abdomen, then suddenly realize how tender and slightly painful the area is. So, I try to be conscientious about how I am leaning into things, especially when cooking.
As far as things rubbing on the skin, there really isn't too much I can do other than wear as loose of clothing as I can. At least, that's all I've been able to figure out thus far.

My appetite remains consummate with my activity level, which is very good. My fluid intake is still between 2.5L-3L every day. With my recent weight gain, I am trying to keep that intake closer to 2.5L since I am obviously not voiding everything I drink. I am planning to do a 24-hour urine draw to determine the disparity between my fluid intake and output. I will try to remember to note that in my next blog.

And that is all I have for now.

I will let you know how things go regarding my BP and weight rise.

Until then, enjoy every day and keep looking towards a bright tomorrow!

Good Health to All!

ScottW