01 Oct 19 Labs:
*Creat: 2.60 (+0.16)
*HCT: 36.6 (-0.4) IR
*Hemo: 11.6 (+0.2) IR
*Lymph: 13.8 (+7.9) Low
*Lymph ABS: 0.9 (+0.4) Low
*Neut: 77.9 (-3.3) High
*Neut ABS: 5.2 (-0.4) IR
*RBC: 4.1 (+0.15) Very Low
*WBC: 6.6 (-0.3) IR
*BUN: 37 (-2) Extremely High
*CA: 9.0 (NC) IR
*GFR: 26 (NC) Extremely Low
*Gluc: 98
*K+: 4.6 (+0.2) IR
*NA+: 138 (NC) IR
*MG: 2.0 (NC) IR
*Phos: 3.5 (+0.1) IR
NC= No Change IR= In [Desired] 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)
*Once again, all U/A readings are exactly the same for--I think--the fourth month in a row!
The good news mostly revolves around three key results: the Hematocrit, Lymphocytes/Lymph ABS and the Red Blood Cells. All three of these are up.
I am happiest about the rebound of the Lymphocytes from 5.4 to the current 13.8. I was worried that there would be another drop in my immune system, putting me at further risk. Though still slightly lower than what we want as the low end of the scale (15.5), at least now I can relax a bit whenever I am out and about.
The Lymph and Lymph ABS go hand in hand; so as one rises, so does the other.
My Red Cell count also rose nicely, going above 4.0 once again. Though there is still a ways to go before hitting the minimal 4.50 reading, it looks like the RBC production is back. Let's hope for another increase in a month.
The stability of my Urinalysis is exceptional! The kidney continues to filter properly, and along with most of the results above, seems to be performing its functions well as it communicates with other systems.
Lastly, my Calcium was stable yet again. This is terrific news!
A few hours following my lab draw, I had my Belatacept infusion. The stick/cannulation went well, though it was painfully placed in the crook of the Left wrist due to the nurses wanting to let my lower arm veins rest for another month following the rough ER stick that left my arm bruised. Other than that, the Infusion went well, and as in now normal, there have been zero appreciable side effects.
Next, my TMD headaches have been elevated again; though with the rough time my body had this past month [with the vertigo episode and flu shot side effects], I am not one bit surprised by this.
Though I had to use my strongest pain med twice last month, the T3/Excedrin combination has done well in keeping the headaches from exploding. With some toleration of pain on a number of days, I was able to use my T3 prescription over a full thirty days.
On this front, I discovered something that may be artificially contributing to my headaches. With a now clearer mind, I was reading over the side effects of my meds once again, and discovered that both the Protonix (for nausea associated with daily meds), and the Isosorbide (for strengthening the heart) have the probability of increasing headaches.
Now, this does not eliminate the TMD involvement whatsoever. The indication for this are unmistakable. However, these two meds may very well be exacerbating the severity of my headaches.
Based on previous experience, I cannot eliminate the Protonix without also eliminating the Isosorbide. To that end, I have a follow-up appointment with my Cardiologist on Halloween Day, 31 October. While there, I am going to discuss the possibility of omitting the Isosorbide (and thus the Protonix), and replace the Iso with Atenolol, a BP med that I used for years, and which was well tolerated with few side effects.
IF I can do this, then there is a strong possibility that the intensity and overall frequency of my headaches will drop. THAT would be most welcomed!
I will let you know how that discussion goes.
My weight has been fairly stable, ranging from 124.5 Kg to 127.0 Kg over the last few weeks. This morning, I weighed in at 125.5 Kg.
As always, my nightly urinary voiding contributes to both the rises and falls in my weight. Last night, I got up three times and lost 1.7 Liters in total, which helped my weight decrease. Conversely, when I have nights that I get up less and only lose 800 cc's of fluid, then my weight either rises, or stays the same.
What I have found interesting on my nightly output is that, when voiding lots, my urine is very lite in color, with little odor; but when I void less, the color is yellow and carries a strong smell. I don't really know that this means much, other than the total nightly volume that is lost determines whether or not the urine is clear versus concentrated...at least that is MY observation.
And on this topic, my daily fluid intake has been consistent at 110-120 ounces. The majority of this fluid is water--about 70%-76% of total intake; which is excellent.
As I have discussed previously, I need to keep my current fluid intake in the above range so that the kidney can keep up. However, once I am able to be more active and begin losing fluids via sweating (Evaporation and Radiation), and increased and deeper breathing while exercising (Respiration)--these represent 3 of the 5 methods of heat loss, which also includes fluid loss, too--then I can increase my fluid intake simply because I'll be using more fluids that do not exit my body via the kidney.
My sleep has been, for the most part, pretty good. Most nights I have been getting between 6-8 hours, though the restfulness of that sleep is not always the best. This of course leaves me feeling tired, but I push through as best as I am able.
Also, my dreams have been completely in my control, and I can still subconsciously trigger myself awake in the rare event of dreaming something that I can't alter. I had an instance of this happening about a week ago, and I don't know why I triggered myself awake.
I remember suddenly waking up in the middle of the night (having had no bad dreams) and asking myself, "Why did I trigger myself to wake up? I wasn't have a bad dream." I do not remember the dream, but I know it wasn't anything terrible. So obviously, my subconscious wanted to avoid something.
My energy and endurance are increasing only incrementally. The process is so slow and laborious that I don't even notice the increases until I have a day that does not leave me exhausted, and I suddenly realize that I did better than expected on that particular day.
So, remember...patience. Always patience.
Next up on my calendar, I have a two-year follow-up with my Oncologist on the 17th, just to discuss how I am doing, and whether or not I should have more tests. After that, my Labs and Belatacept Infusion on the 29th (remember, both are every 28 days; so October and May will usually have two Lab Draws/Infusions in one calendar month). Then, that Cardiologist visit on the 31st. Of course, I will let you know how all appointments go.
That's all I have for now.
Good Health to All!
ScottW
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