Post-Transplant Update: 24 May 2019

Over this past week, there have been few new developments, so this entry will be fairly brief. 

My daily vitals have been stable. As per usual, my morning and evening blood pressure (BP) readings are divergent from each other. While the difference is now less following the partial parathyroidectomy, it is still there. As I stated in last weeks' entry, the Clinic doctors are unconcerned by that at this time, so I won't worry too much about the AM/PM gap.  
On the other hand, my average pulse rate is in the mid 60's, which is excellent!     
As far as my weight...I seem to have stalled in my downward vacillation, hovering at or near 125 Kg's. 


Yesterday, I finally finished the latest puzzle that I have been working on for several months. The reason it has taken so long is because it is a "Challenge" puzzle of 1,000 pieces, and with similar patterns of color and shape throughout. A good early session on the puzzle was 2-3 pieces. Some days, I got nothing done. As I put more pieces in place, the puzzle went faster as there were fewer and fewer pieces to sort through; less patters to evaluate and identify.  Below is a picture of that puzzle:

This particular puzzle, though frustrating to even get started, was a great exercise for my recovering brain. It really helped me to settle my mind away from frustration and  towards problem solving, and seeing more intricate patterns. 

The next puzzle I will do will not be so difficult; which I will start on this weekend.

On the TMD front, I had a small victory this past month. Let me explain...

Ever since my Abdominal Hernia surgery (and all the terrible resultant pain), my T3 usage has been one month of meds taken over about 26-28 days; or, about 3.15 tablets per day. This usage was consistent...until my latest Rx was done. I started using that on the morning of 22 April. I finished that bottle of meds in the morning of 22 May, for a solid 3.0 tablets per day.  I know, that doesn't sound like a big drop; but it is the first time since that 2017 surgery that I have been able to go a full 30 days on one allotment of meds. Plus, as I stated last week, I had several days that I took only one T3. 

This small victory gives me even more hope that I am finally on my way to getting to the point of completely controlling the TMD headaches once again.

My energy this past week has been low; but considering how much I had to do from Tuesday (14 May) until Monday morning, I really am not surprised that my body is tired. However, I have to look at it from the perspective of my having enough healing and physical energy that I could do so much solo driving, and so many errands in the first place! This is terrific progress, even if I have to take a step backward for a few days.

Again...small victories!

My sleep has been OK; my appetite is consummate with my overall activity level; my water intake is a solid 2.5 Liters every day (plus other fluids) and I am feeling like I am moving slowly forward. A long road to overall recovery still lies before me, but I am seeing clear signs that I am on my way.

I hope that all of my U.S. readers have a safe Memorial Day weekend! Please take a few minutes to remember those who gave their lives so that we all can enjoy the freedoms that we live with every day. Without their sacrifices, our lives would be vastly different!

Good Health to All!

ScottW

Post-Transplant Update: 16 May 2019

My apologies for taking too long to write this entry. I just failed to sit down and get it done. However, with the last two days now done, I am finally getting caught up.

Tuesday (14 May) I had my monthly labs and infusion.

14 May 19 Labs:

*Creat:   2.88 (+0.23) 

*HCT:   35.2 (-0.3) IR

*Hemo:   11.3 (+0.2) IR

*Lymph:   15.4 (+1.6) IR (Low End)

*Lymph ABS:   0.9 (NC) Low

*Neut:   76.1 (-0.7) High

*Neut ABS:   4.6 (-0.1) IR

*RBC:   3.97 (+0.03) Very Low

*WBC:   6.1 (-0.4) IR

*BUN:   42 (+2) Extremely High

*CA:   9.9 (NC) IR

*GFR:   23 (-3) Extremely Low

*Gluc:   96

*K+:   4.3 (-0.1) IR

*NA+:   138 (NC) IR

*Prot:   7.1 (+0.1) IR

*MG:   2.2 (NC) IR

*Phos:   4.3 (+0.2) IR

*PTH:   63 (-58) IR
            NC= No Change     IR= IN Range

The labs are looking really good, overall.  The Lymphocytes, while still a touch on the low end of the range, still show stability. There is still lots of room for immune system strengthening; but I am glad that this reading is stable!

The latest Parathyroid Hormone (PTH) reading came back in fantastic shape! I think that the April reading of 121 was simply an anomalous reading. The surgeon has already contacted me and is extremely pleased with both the PTH and CA readings. Plus, I am to continue with my current calcium supplement intake (Tums, 100 mg 4x/day), and no other changes or concerns.  So, terrific news there!

The Creatinine reading will be discussed in just a bit.


Urinalysis (UA) 14 May 19

Appearance:   Normal

Color:   Normal

Glucose, UR:   Negative

Hgb,UR:   Negative

Ketones, UR:   Negative

Leuk Esterase:   Negative

Nitrite:   Negative

pH, Urine:   6.0 (Normal Range is 5.0-8.5)

Prot, UR:   Negative

Specific Gravity, Urine:   1.01 (Normal Range is 1.003-1.030)

The only change on this month's UA is in the Protein. It has gone from a trace in April to negative this month. Again, renal filtering is going well.

My Belatacept Infusion [on Tuesday] went well. The IV canulation was easy, and the infusion went off without any issues. As is now the pattern, I have had zero side effects from the medication--which continues to be 600 Mg in 100cc of Normal Saline (NS) given over 30 minutes.


Now, yesterday (Wednesday, 15 May) I had my two year post-transplant follow-up with the Kidney Clinic. As always, we discussed meds, compliance with renal care instructions, physical exam and answering any questions I might have. 
In summary, the Clinic doctors are extremely pleased with my progress, and have no changes or further instructions, at this time.
As for my current Creatinine reading of 2.88, they are not yet concerned, as muscle building increases the normal Creatinine levels. IF this gets over 3.0, they could order new tests to determine if anything untoward is causing the increase [other than muscle growth]. 

And speaking of my two-year follow-up, I cannot believe that I have already had my kidney for two full years! May 4th (Star Wars Day) is my "Kidney-versary". 
Despite all the struggles that have occurred since the transplant, the kidney is finally strengthening and functioning nicely; as well as is my immune system. It has been a very long, arduous road to get to this point; but I wouldn't trade it for anything!


On other areas, I am getting my walks in probably 3-4 times each week, depending on things that are going on from day to day. Last week, I decreased my brief walk of about 250 yards (mostly on a slight uphill gradient) from 7:37 to 6:36.75. Though the walk still exhausts me, it is very encouraging that after only a relatively few walks, my time is already decreasing. Once my time lowers to about five minutes, I will likely increase the distance incrementally. Of course, I will keep you updated on my progress.

Next, my TMD is finally settled down to a somewhat normal level. It is hard, when talking about TMD and its associated headaches, to describe "normal." Being subjective, it means one thing to me, but something else entirely to someone else. Anyhow, with the headache intensity and frequency lessened, I haven't taken any strong meds in about three weeks. Unfortunately, my T3 usage is still averaging about three per day. On the plus side of that news, I have already had several days that I took only one T3, which is an excellent sign that I may finally be on the upside of knocking these headaches down again. 

My weight seems to have plateaued over the past week or so. I hit a high of 126.6 Kg's on 02 May; but my current weight is 125.4 Kg. I have seen a recent downward vacillation  that will hopefully continue.

On other, infrequently discussed topics: 

The Neuropathy in my feet seems to be getting slowly better. I am wearing shoes now on my walks, and when I drive (which I have been doing barefoot because I can't feel the pedals through shoes) in order to help my feet get used to having the irritation increase. I am hoping that between these efforts and acupuncture, I might be able to wear shoes all the time within a month or two. (Though I am cautiously pessimistic that that will actually happen anytime soon.) At least I am on my way to getting back into shoes.

Since the recent tooth repair, I have had no further issues. Plus, my wife noticed that my teeth have naturally whitened slightly since the partial Parathyroidectomy, as if the calcium and other nutrients are finally reaching the teeth. 

My sleep has been pretty good each night. I am generally getting between 6-7 hours of decent sleep, though that changes whenever I have to get up more that two times to relieve my still under-sized bladder. Most of the time I can get back to sleep; but once in a while, I have to get up after taking an hour to get back asleep. 

And speaking of my bladder, the absolute most that I have had it hold was 650 cc's...but that was only after I was dead asleep for too long, and I literally bolted up out of sleep (and the bed) in order to hit the restroom. Most nights, I average between 300-500 cc's, and from 2-5 times each night; which makes a no average nightly total between 700 cc's - 2 Liters. (Like I said...no nightly average for urinary voiding.) The Clinic doctors frankly don't know if I can expect my bladder to increase in holding volume. I hope that it does; but if it does, that could take some time.


And with that, I will conclude this edition of my blog.

I hope that each of you, my readers, are doing exceptionally well, and moving ahead towards your goals despite any and all opposition!

Good Health to All!

ScottW