Post-Transplant Update: 20 July 2019

As it has been longer than I had intended to write this entry, I have several things to discuss, so let's get right to it!

09 July 16 Labs:

*Creatinine:   2.78 (-0.11)

*Hematocrit:   36.7 (+0.8) IR

*Hemoglobin:   11.6 (+0.1) IR

*Lymphocytes:   10.6 (-2.4) Low

*Lymphocytes Absolute:   0.7 (-0.3) Low

*Neutrophils:   78.8 (+1.0) High

*Neutrophils Absolute:   5.3 (-0.4) IR

*Red Blood Cells:   4.05 (NC) Very Low

*White Blood Cells:   6.7 (-0.7) IR

*Blood Urea Nitrogen:   38 (+3) Very High

*Calcium:   10.0 (+0.2) IR

*Glomerular Filtration Rate:   24 (+1) Extremely Low

*Blood Glucose:   95 (NR 80-100, so this is perfect)

*Potassium:   4.3 (-0.2) IR

*Sodium:   142 (+2) IR

*Protein:   Not Taken

*Magnesium:   2.0 (-0.4) IR

*Phosphorous:   4.3 (+0.7) IR

          NC=No Change     IR=In Range    

The Creatinine actually dropped for the first time in several months, which was a nice surprise. Let's hope for either another reduction in August, or at least no change in the reading.

My Lymphocytes dropped unexpectedly following a few months of stability at the low end of the desired range. Even though my WBC count is good, with the Lymphocytes down, it is time to go back to wearing the mask whenever I am out in enclosed public spaces, and just being extra cautious in general.

Lastly, my Calcium reading was at the very top of the range that my Parathyroid doc was wanting, so I called his nurse for instructions. He said that I am to reduce my calcium supplement (TUMS) intake in half, going from 1,000 mg 4x/day to 1,000 mg 2x/day. Apparently, what little bone hunger remained from the whole parathyroid thing has now disappeared. Next months' lab should show if stability with my calcium has been achieved, or if further CA intake adjustments are needed.

Overall, the labs were good. I had eight lab values in the proper ranges, a good Blood Glucose Level, the drop in Creatinine and steadiness with my electrolytes.   The continued low BUN and GFR are concerning, but unless I hear from my nephrologist or the Transplant Clinic, I'll just keep moving forward.
It was nice to see that my Hematocrit was up to an almost normal level [for a renal transplant patient]. This is a strong indicator that the kidney is managing--despite my low RBC--the proper proportion of Red Blood Cells within the total blood volume in my body. In simplified terms...no anemia.


Also on 09 July, I had my monthly Belatacept infusion; my main anti-rejection med. Aside from a missed cannulation, the infusion went well, and there are once again no side effects...aside from a nice big bruise (contusion) on my arm from that failed stick.


Earlier this week (Tuesday, 16 July) I had my annual wellness exam (as required by my insurance). All was as well as could be expected as my healing and strengthening continues. The doctor (a General practitioner) was pleased with my progress.


As far as other upcoming exams, I have a scheduled visit with a Dermatologist in 
mid-August.  Also, I am still working on the other appointments that I spoke of in my last entry. 


With the heat in my area--as is usual in the summer in a high desert region--I have not gotten out on any walks since my last entry. It is hot outside in the morning, afternoon and evening. However, with doing housework, I am getting exercise in by walking up and downstairs multiple times every day; on the order of 10-15 times. Add in the actual housework, and my strengthening continues its slow--sometimes agonizing--pace. Again, the way I must look at my progress is to concentrate on the small victories...getting 2.5 bathrooms cleaned without exhausting myself; vacuuming the stairs with increasing ease; having enough energy to accomplish multiple things each day, etc. 


My feet have seemed to heal a little more from the dialysis-induced neuropathy. This past week I began to notice different areas of both feet feeling different than the usual burning and extreme numbness. While my toes continue to be so numb that I cannot feel them, my heals and balls of my feet have spots that either have a little feeling emerging, or almost feel slightly normal. The areas that this is happening aren't huge by any stretch; but the fact that I am feeling sensations in varying parts of each foot is very encouraging!

Lastly, I quickly finished that 500 piece puzzle that was next in line. Aside from the initial sorting of the pieces, I took only about 4.5 hours over about a week to complete this puzzle. (The photo is below.)
Since my daughter has yet to purchase that puzzle of the signing of the Declaration of Independence, I do not yet have another one to work on, but am looking.

And that gets me caught up!

I hope that you all enjoy the coming week! Enjoy your summer, and stay hydrated and healthy!

Good Health to All!

ScottW

Post-Transplant Update: 03 July 2019

To start off, do you remember that I started another puzzle in late May after taking months to finish to previous (and extremely difficult) puzzle? Well, I finished the latest puzzle in less than a month. In total, I put in between 12-15 hours of work to complete the project. What is good, is that I am even better able to see the intricate patters of colors, shapes, etc in this 1000 piece, 26" x 26"  puzzle. The whole project took less time than I was anticipating.

The next puzzle will be smaller--just 500 pieces--but is a nearly monochromatic print of the Grand Teton mountains.

Next, more good news on the TMD headache front. Following the previous month of T3 usage (a 30 day Rx that was fully used over 30 days), my late-May to late-June Rx actually lasted a full 31 days! In early June, I had about seven or eight days wherein my headaches were actually minimal, and I was taking just 1 T3 each day, as well as Excedrin the rest of the day. During that time, my average daily usage of T3 fell from 3/day down to 2.35/day! This was excellent! And I can absolutely tell you how nice it was to have my headaches most controlled by regular OTC meds for awhile!
Unfortunately, the TMD decided to rear its ugly head once again, and the headaches and intensity both increased again; just as I said it likely would. During this time, I saw my daily average usage slowly increase to 2.5, then 2.7. At the end of this 31 days of the Rx, my daily average T3 usage was at 2.90. I think that for the first time since the TMD re-emerged (back in 2010), I am finally seeing a reduction in meds (both Rx and OTC) to control the headaches. Finally!

My walks have grown infrequent the past couple of weeks as I have not been sleeping well, and have just been tired most of the time. I don't know why my sleep has been so bad because I am dreaming just fine, am controlling my dreams all the time, and am sleeping between 6-8 hours each night. I am just not resting as well as I should be.

My nightly urinary output continues to vacillate, but I am remaining pretty steady with my weight. I will increase or decrease [my weight] anywhere between 0.0 -0.9 Kg from day to day. So, even thought my nightly output is erratic, my total daily output is consistent.

My abdomen is still sore from the hernia repair; though it is definitely better than it was, and is getting a little better every day. I noticed a few weeks ago that I can actually rest my hands on my upper abdomen without pain...for a time. However, direct pushing contact is still painful, and I still have muscle spasms in both the upper and lower abdomen over the area of the sutures used to stabilize the mesh. These spasms are becoming less frequent. Plus, I have little pain these days from the intercostal muscle cuts; which is great!

The neuropathy in my feet is still healing...very slowly. While I haven't needed to use any ice baths lately, the heat and numbness can get intense. On a good note, I am starting to notice different areas on my feet that are feeling less numb. 

Coming up this month, I have labs and Belatacept infusion next week, my yearly appointment with a cardiologist, a physical exam, and am working on getting appointments with a dermatologist, oncologist and scheduling an overdue colonoscopy. While these all won't be this month, it is time I get these visits done.

With that, I want to wish you all a Happy, Safe and Enjoyable 243rd Independence Day!    I also encourage you to take a few minutes to reflect of those great men who sacrificed so much in order to set us on the road to freedom. They should never be forgotten, never taken for granted, and always acknowledged for what they did for all of us today!

Happy 4th of July!

ScottW