Post-Transplant Update: 31 October 2018

Yesterday was a busy one.

First, let's take a look at my weights and BP over the past week...

My weight has been fairly steady due to my self-imposed limit on fluid intake of around 2.5 Liters per day. I started the last week at 119.1 Kg, fell down to 118.1 Kg, then rose again to 119.4 yesterday. This morning, I was at 119.1 Kg once again. 
Also, urine output has gone hand in hand with my weight loss. On the days I void fluids regularly, I have to pee every two hours, like clockwork. This includes when I sleep. This is also on days that I lose fluid weight.
On the days I gain weight, I am voiding fluid between every 3-5 hours, and only awaken one, maybe two times at night. 
Though I had planned to do a 24-hour urine draw, on the day that was to happen, I was feeling lousy, and just didn't get a single output measured. 

With the blood pressures, I have been using the Clonidine (BP med) almost every day both day and night. Despite this effort, my A.M. pressures have ranged from 127 (systolic) to 148. Diastolic readings and pulses are acceptable.  The P.M. pressures range from 137 (systolic) to 165. The evening diastolics are high and range from 75-100. Pulses are good.

Next, my latest visit with the Kidney Clinic doctors happened just yesterday morning. They listened to my concerns about the recent trends in the BP, Weight and Urine output inconsistency, and they agreed that this exact set of trends led up to the occluded renal artery. So, I am scheduled to do a Renal Ultrasound tomorrow morning. I will give you the results when I get them.  
The doctors also agreed that a Renal Angiogram with balloon expansion of the artery is likely. They want to get ahead of a probable growing occlusion before it becomes critical; and I couldn't agree more! No more hospitalizations for a while.

Also during the Clinic visit, my intake of Sodium Bicarb was reduced to 2 tablets (325 mg ea.) twice each day--down from 3 tabs 2x/day. All other meds are staying as established.

The doctors were also pleased overall with my latest labs. Let's look at those...

30 Oct 18 Labs

*Creat:   2.45 (+0.08) Still settling. (The rise could be due to suspected renal artery occlusion)

*HCT:   32.9 (-1.3) Low

*Hemo:   10.1 (-0.3) Acceptable

*Lymph:   2.8 (-5.6) Extremely Low

*Lymph ABS:   0.2 (-0.4) Extremely Low

*Neut:   81.1 (+2.0) Very High

*Neut ABS:   5.2 (-0.1) IR

*RBC:   3.58 (-0.14) Very Low

*WBC:   6.5 (-0.2) IR

*BUN:   43 (+9) Extremely High (Again, possibly due to artery)

*CA:   10.0 (-0.1) IR

*GFR:   29 (-1) Extremely Low

*Gluc:   95

*K+:   4.5 (-0.1) IR

*NA+:   141 (+1) IR

*Prot:   6.8 (-0.3) IR

*MG:   2.3 (-0.3) IR

*Phos:   3.5 (+0.1) IR

*BK:   Not Checked

*CMV:   Not Checked

     NC= No Change     IR= In Range

While the Hematocrit, RBC's and Hemoglobin are fairly steady, I am only highlighting the Lymphocytes. Once more, we saw a rise last labs, and another drop this time. The Lymphocytes should start to settle into more of a stable range in the near future. We are already seven months post-rejection episode (of the six to nine month recovery for labs), plus the probable renal artery opening should combine to result in helping this to stabilize soon.

Also, the doctors were absolutely thrilled that I am going on a cruise at the end of the year! They have zero reservations aside from being sure I am as hygienic as possible. 

What else...

The headaches continue. I have had to use stronger meds twice this past week in order to knock down the pain for a few hours. The breaks from the intense pain were nice.  Aside from those two exceptions, the TMD pain has been constant; day and night. I am somewhat managing to keep the headaches in check with T3 and Excedrin. The caffeine in Excedrin helps to 'potentiate' the T3 so that the pain med works better. I try to stick with 1-T3 and 1-Excedrin at a time as I am limited to 3,000 mg of Tylenol per day (for the health of the kidney). Sometimes, I must use a second T3 to get the pain under control.

Next, I had my latest Belatacept infusion yesterday afternoon. The cannulation was excellent, and the med delivered without a hitch. So far I have had zero appreciable side effects. Hopefully, this stays the same. My next infusion will be on 27 November.

As I go about my daily routine, I try to be a tad more active from day to day. I am doing the stairs in our new place  numerous times each day, and I now rarely hold the railing whether going up or down. Plus, my wife and I are walking a circuit of 4/10's of a mile 3-4 times each week. On the uphill I am still using the cane; but on the downhills or flats, I walk without the cane. The longer we do the walks, the stronger I will get, and the cane will soon be unneeded.

I only had one bad day this last week when I just felt off all day. Though I do not know why I felt like this, I took two naps of 1.5-3 hours each, and had a bout of diarrhea. When I awoke the next day, I felt better. 

That's all I have for now. IF the results from the ultrasound [tomorrow] come back quickly, I will report that below. If not, I will post them on my next blog.

Until then...

Good Health to All!

ScottW


01 Nov:   The Renal Ultrasound went well. Of course, the tech could not say what they saw, so I know nothing.  I did, however, call my Transplant Coordinator to inform her that the test was completed. I might know the results tomorrow, or next week.