Post-Transplant Update: 21 February 2020

Well, I'm a day late on getting this started, so lets go right to the labs...

17 Feb 20 Labs

*Creat:   2.71 (NC)

*HCT:   38.7 (+0.5) IR

*Hemo:   11.8 (-0.2) IR

*Lymph:   13.5 (+8.2) Low

*Lymph ABS:   0.9 (+0.5) Low

*Neut:   77.1 (-1.1) High

*Neut ABS:   4.8 (-0.4) IR

*RBC:   4.23 (-0.01) Very Low

*WBC:   6.3 (-0.3) IR

*BUN:   38 (+5) Very High

*CA:   9.0 (NC) IR

*GFR:   25 (NC) Extremely Low

*Gluc:   103

*K+:   4.2 (+0.5) IR

*NA+:   138 (+1) IR

*MG:   2.1 (NC) IR

*Phos:   4.0 (+0.7) IR

          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:   1.015 (Normal Range is 1.003-1.030)

My labs this month look good. Though the BUN remains far too high, and the GFR is way too low, my Creatinine held steady--which is great!-- my Hematocrit increased for the second or third month in a row, and once again, my Lymphocytes (and ABS) took a big jump after the most recent precipitous drop (...the yoyo continues...).

My Urinalysis looks great! The kidney appears to be filtering very well.

The monthly infusion of Belatacept went well; aside from an extra attempt at cannulation. As is now normal, I have had zero side effects from this med that once saw me label each infusion as 'the Belatacept Blues' due to the excessive intestinal gas and soft stools that would happen for months following my getting on this vital med. I am soooooo glad that those days are behind me! (Yes...pun intended!)

My headache this past week have been manageable. My daytimes have usually been good, with any headaches controlled with Excedrin. However, the evening have seen the headaches increase so that have to take the T3/Excedrin combo. 

The best news on the TMD headache front is that my average daily T3 usage has fallen to 1.8 tablets! This is a terrific decrease in both headaches and med usage!

Hope remains that I will conquer the TMD once more!

My weight has stayed steady, ranging between 121 Kg's and 122 Kg's. The days that I take the Torsemide no longer see my urine output exceed my intake by huge amounts...only small ones of 0.5-1 Kg. However, on the non-Torsemide days, I just retain that fluid once again. So, no win, no loss overall.

Energy-wise, I am still getting incrementally better. I did grocery shopping last evening, and after three stops over about three hours, I came home, put the groceries away...and wasn't exhausted!    Tired, yes. Just not so exhausted that I could hardly move.

So, I'm seeing good progress on this front.

The neuropathy in my feet also improves in very small increments. The numbness has decreased significantly in both feet; but the pain lags behind that improvement. I have actually had a few more  small areas on my feet that feel less pain and heat; but the overall majority of both feet remain tender and hot.  I have been thinking that I may need to examine newer pharmaceutical options for reducing the pain so that I can get shoes on for more than an hour. I will be doing some research on what might be available, and whether or not any of the options are compatible with my meds.

Well, that's all I have for this entry; some decent or good progress all around. (How long has it been since I've been able to say that?)

My next scheduled appointments are both coming up in March. One with my Nephrologist, and one with the surgeon who excised three of my Parathyroid glands. The surgeon just wants a routine follow-up, and likely discuss my daily Calcium intake.

Plus, my next labs and infusion are on the 17th.

With not much to discuss right now, it might be a couple of weeks before my next entry.

Until then, may you all enjoy what remains of the Winter of 2020, and remain safe in all that you do!

Good Health to All!

ScottW

Post-Transplant Update: 12 February 2020

I had planned on getting this post written last week; but a series of escalating TMD headaches made me postpone pretty much everything.

It started last Monday afternoon (03 Feb) with a creeping headache that slowly worsened as the day went along. On Tuesday, the pain increased to a solid 9 all day, which forced me to take my strongest pain med. This helped ease the headache down to a 5, or so; and stayed that way most of that Wednesday. But on Thursday, the pain ramped up once again, hitting and staying on a good 7. The headache was somewhat manageable all day and that night.
But on Friday it kicked up yet again and stayed there for three more full days, sitting at an unmovable 10...not budging one bit, even with strong meds all three days. 
It was a doozy! 
I was photo and audio sensitive, and not only had the shades drawn all three days, but I also wore my sunglasses in the house to help alleviate the intense pain! Plus, sound had to be kept low, as well. Finally, late Sunday evening, the headache finally began to ease. By Monday morning (10 Feb), it was minimal once more. What fun!

I spent all of Monday with that minimal headache, which was well-managed with just Excedrin. It was a welcomed relief!

Yesterday, I had my follow-up visit with the Kidney Clinic. The doctors are pleased with my weight loss, as well as my lowered blood pressures. They made two changes to my meds: 1) I am to take the Torsemide every other day, from now on, unless any untoward side effects occur.  2) My twice-daily Clonidine has been increased to 0.1 mg both morning and evening. I was already on 0.05 morning, and 0.1 evening, so doubling the morning dose is no big deal.
I am to maintain this overall dosing regimen until at least my next yearly review, which is coming up in May; unless--again--something in my labs or daily vitals goes wonky. IF that happens, I'll just call the Clinic and proceed from there.

One of the doctors explained why I will continue with the Torsemide...

When you are on several BP-controlling meds, the body just needs some help getting rid of all of the fluids you take in; hence, a regular diuretic. I cannot explain the pathophysiology of the whole interaction, but that is the reason I might continue using a diuretic for the foreseeable future.


My daily BP's have been doing better, but are still not stable. The morning systolic readings range from the mid-100-teens, up to the mid 130's; while the evening readings range from the high 120's to the high 140's. 

My weight has stabilized around 121 Kg's. It will rise one day, then dip into 120 Kg's the next; so 121 Kg's seems to be the current norm.

With the twice daily uniform dosing of the Clonidine (in conjunction with the other BP meds), it is hoped that I will finally see stable, consistent blood pressure readings both morning and evening.


My sleep has continued to be decent in overall hours, but still poor in quality as I have been somewhat dragging around...headache aside. 

My energy is still increasing little by little. While there are days that are better than others, I find that I am walking a bit faster, climbing the stairs in the house with greater strength, and have days that find me getting a bit restless; which is excellent!

I think that I'll end this entry there.

Next week I have my monthly Labs and Infusion of Belatacept. I will post those lab results either next Wednesday or Thursday.

Until next time...

Have a terrific week, and remember to always smile!

Good Health to All!

ScottW