Post-Transplant Update: 05 September 2019

My latest monthly labs were done earlier this week, as well as was my monthly infusion of Belatacept.

Before I get to that, a few updates from my last entry.

As mentioned previously, the skin tags and cyst that were removed by the Dermatologist were sent to pathology. One week later, the results came back as completely benign on everything, so there is no danger of possible skin cancer development.

The sutures took almost two full weeks to dissolve, and the cyst removal site is healing nicely. It is still too early to determine if the scar will be obvious, or miniscule. My foreheard though, is no longer painful; which is great!

The sites [in my armpits] that the tags were removed took until last week to stop hurting altogether. The sites are still visible, and may be for a while yet.

Also, in early August I began to wean myself off of Protonix (Pantaprozole), which helps alleviate an upset stomach due to all of my meds. I tried this because I know that long-term usage can lead to gastrointestinal issues, which I want to avoid. In total, I took three weeks to eliminate this med from my daily intake.

Unfortunately, within a few days of starting this process, I began to have low grade nausea. By the time I was down to one med every three days (then no med afterwards), I was feeling nauseated most of the time; plus I would burp up stomach acid, and taste iron, as if I was burping blood. Additionally, my energy level plummeted, and aside from cooking, I was getting nothing done around the house from day to day.

At this point I discussed this with my wife and decided to go back on the Protonix until such time as the heart meds I am on (Isosorbide, Hydralazine, Carvedilol and Sodium Bicarbonate) are finally eliminated from my daily use.

This decision came about because the nausea, nasty burps and general malaise had all happened one year ago (and after the rejection episode) when I was ordered to stop using the Protonix[yet still taking all of the heart meds]. Within a few days, the negative effects had kicked in, and the Kidney Clinic docs told to to restart the Protonix; which immediately eliminated the issues.

And just like a year ago, as soon as I began using the Protonix again, all the negative symptoms were gone; though it took about a week for my energy to improve.

OK...now the lab results:

03 Set 19 Labs

*Creat:   2.59 (+0.15) 

*HCT:   35.6 (+1.1) Slightly Low

*Hemo:   11.2 (+0.3) IR

*Lymph:   7.9 (-4.9) Very Low

*Lymph ABS:   0.6 (-0.2) Very Low

*Neut:   81.3 (+0.4) Very High

*Neut ABS:   5.6 (+0.3) IR

*RBC:   3.95 (+0.09) Extremely Low

*WBC:   6.9 (+0.4) IR

*BUN:   35 (-4) Very High

*CA:   9.5 (-0.3) IR

*GFR: 27 (-1) Extremely Low

*Gluc:   99

*K+:   4.6 (+0.1) IR

*NA+:   138 (NC) IR

*MG:   2.0 (+0.1) IR

*Phos:   3.4 (-0.4) IR

*Prot:   No Longer taken.

          NC=No Change     IR-In Range

*Urinalysis:

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:   1.013 (Normal Range is 1.003-1.030)

(*This reading is exactly the same as last month!)

The Creatinine , though up slightly, appears to be stable; which is awesome!

The RBC's rose slightly [following last months' drop], so it was nice to see this.

My Calcium dropped slightly to more of a mid-range that the Parathyroid surgeon was wanting. This means that my lower intake of Calcium (from 4,000 mg/day to 2,000 mg/day) was successful. I called the doctor to ask if he wanted anything changed, and was given a 'No'.

On the side to worry about are the Lymphocytes and Lymph ABS readings. I had been hoping that both would rebound from the drop we saw in August. The large drop this month was definitely troubling. Once again, I must take the now all too familiar precautions until it strengthens once more. While I am probably not in too much danger because of the White Cell count, it is still prudent to be cautious and not test the strength of my immune system. Any exposure to the wrong bacteria, virus or other compound could lead to my losing the kidney. So, just like the Transplant Team doctors, I choose to err of the side of an abundance of caution!

Overall, there is a lot of stability. I am definitely encouraged by the constancy of the Urinalysis which, for the third month in a row, showed that the filtering ability of the kidney is working well.

What else...

The monthly infusion [of Belatacept] went well; aside from needing to scan my L arm for a good venipuncture site. There were no complications, no side effects. And, as my wife quipped, I "get to live another 28 days!"

My sleep has been good the past few weeks, but the quality of that sleep has not. As to why this has been happening again, I do not know. I am sleeping between 7-8 hours each night, am controlling my dreams well, and get back to sleep after I have to get up to relieve my bladder (between 1.0 L-1.6 L per night). In other words, there is nothing obvious that is impacting my ability to get restful sleep; which leaves me wondering why it is happening at all.

The TMD headaches have been up again. However, like the previous month, I was able to make the 30-day supply of T3's last the entire month; which is great! However, in order to achieve that, I have been using straight Excedrin too much, trying to tolerate the headaches, which only ends up making them worse. Sometimes, trying to be judicious in med use works against me in the ongoing fight to reduce these headaches. 

However, if you do not try to use OTC analgesics, you will never know if the headaches are reducing.

On the other hand, there were several days in which the headaches were minimal, and I used only one T3, or even none for the day. Again, this gives me great hope that the TMD symptomology will settle down once again.

Neuropathy... On it goes. About the only good news I have on this front is that I have not had to soak my feet in an ice bath in a couple of months now. And that's about it.

I think that that is all I had wanted to mention today.

Upcoming: My next visit with my Nephrologist on 17 September. 

I may not get an update done until then, so don't be surprised if I don't.

Until next time...

Good Health to All!

ScottW


Oh...
I forgot to mention that yesterday, I finished the latest 1,000 piece puzzle. In total, I spent approximately 15.5 hours to complete it. The picture of it is below...