Diagnosed with ESRD - End Stage Renal Disease in 2010 with 28% kidney function left. In January 2013, it dropped to 5%. Started twice a week Hemodialysis in February. My beautiful and courageous wife, Ninette, came forward willingly to be my donor and we started with the work-up in March. We finally finished everything and got approval 08 July 2013. We had the procedure the 25th of the same month.
Our journey continues...
Thursday, July 30, 2015
Saturday, August 9, 2014
Monday, February 3, 2014
|Image from whatisall.yolasite.com|
Spondylosis and Herniated Disc
It is some years now that I have been having a little pain in my lumbar area. It usually comes after long walks or after lifting heavy objects. But a few weeks after the transplant, the pain has more than doubled in frequency as well as intensity even when not doing anything. And because of the pain, I tend to slouch forward and tend to favor one side when walking. Sometimes, it gets unbearable.
So I consult a spinal surgeon with Xray results in hand. The main cause of the pain is degenerative bone disease and some prolapsed disc possibly due to wear and tear(aka age), overuse, misuse or abuse. The pain intensifying after the transplant due to atrophy of the lower back and abdominal muscles. For a time and up to now, overloading these muscle groups are contraindicated for me to aid in healing of the transplanted organ.
The spine doctor prescribed, muscle relaxants, pain meds and posture modification.He told me to keep my back erect when standing, seating or lying down. Good thing therapy and surgery are not options yet. But still, I find myself slouching sometimes as it eases the pain a bit.
A few days after Christmas, I felt that I was developing a blister in my perineal area. I attributed it to too much sitting amidst Metro-Manila’s December traffic and thought nothing of it. It turned out to become a furuncle complete with tenderness and swelling; that’s right, a boil… a pigsa. It was uncomfortable but bearable. Then a few hours before midnight on new year’s eve, I was burning with a 39º temperature. So I texted my neph to inform him as well ask for instructions on what to do. He prescribed paracetamol and antibacterial tablets and he had special instructions… and I quote: Paputukin mo yang pigsa mamayang alas dose!
The paracetamol and antibiotics helped, but my high fever would often recur and I felt really weak and sick. When I went for a checkup, my creatinine was elevated and my urine was positive of protein. An indication of an uncontrolled infection. That same evening, I checked in hospital. Because of my immunosuppressed state, oral antibiotics did not work... I needed mainlining(antibiotics through IV).
The fever gradually went away and the urologist ordered an IND or incision and drainage procedure. So they scheduled the OR and prepped me. But when we found out that I will be under general anaesthesia, we had second thoughts for I had some bad reactions to anaesthesia after my transplant in July. After due deliberation, the doctors decided against the IND and just concentrate the treatment on pumping in the antibiotics to fight off the staphylococci.
I ended up spending 10 days in hospital and 2 weeks of being sidelined from work. And all just because of a pigsa.
I got my latest test results and consulted with my neph earlier today. The numbers are good and creatinine is down. An indication that I am in the correct immunosuppressed level. Hoping for more improved results in 2 weeks.
Note to self: DIET!
Friday, January 31, 2014
Wednesday, September 25, 2013
|Image courtesy of medscape.com|
Today is the second month of my new life, having received a kidney from Ninette, my wife, last July 25. What do young people call this occasion? A monthsary?
I went to see my nephrologist yesterday as a follow up on the oral steroid pulsing he started me on 4 days ago.(See previous post) I had a Renal Allograft Doppler Ultrasound done plus blood tests: Creatinine and BUN. Both the neph and I are happy since the results indicate that I am responding very well to the oral steroid pulsing.
The Doppler Ultrasound did not show any adverse abnormalities and my blood numbers have improved a lot. My Creatinine level went down to 1.9 ml/dL, my best number so far after the transplant 2 months ago. And there's no need for me to be admitted for steroid pulsing via IV.
I'll stay with the current Prednisone level of 60mg per day to check this mild rejection episode and will see the neph again after a week. Then, hopefully, I can again be weaned from steroids. Among the common side effects of high-dose Prednisone are: mood swings, irritability, thrush, increased risk of infection, joint discomfort, high blood sugar, "moonface", acne, high blood pressure, increased appetite, weight gain and fluid retention. So the sooner the dosage is decreased, the better.
Sunday, September 22, 2013
It was rather a busy week for me doing blood tests and consulting with my nephrologist. My serum creatinine level results show an increasing trend contrary to what was expected. And there is a need to identify what is causing it.
My usual weekly lab tests include
- Creatinine - indicator of kidney function; an elevated creatinine level signifies impaired kidney function
- Complete Blood Count - used to evaluate overall health and detect a wide range of disorders; abnormal increase/decrease in cell counts indicate that there is an underlying medical condition that calls for further evaluation
- BUN(Blood Urea Nitrogen) - measures the amount of nitrogen in the blood that comes from the waste product urea which is passed out of the body via urine; if kidneys do not remove urea normally, BUN level rises
- Lipid Profile - measures levels of lipids/fats, including cholesterol and triglycerides; it assess risk of developing cardiovascular disease or to monitor its treatment
- FBS(Fasting Blood Sugar) - indicates the amount of glucose/sugar present in the blood; levels outside the normal range may be an indicator of a medical condition, diabetes in particular
- Urinalysis - checks different components of urine, a waste product produced by the kidneys; minerals, fluids, and other substances from blood are passed in the urine; what you eat, drink, how much you exercise and how well your kidneys work can affect what is in the urine; it helps find causes of symptoms of health problems one may have
- Hemoglibin A1C - diagnoses Type 1/Type 2 diabetes; gauges how well diabetes is managed; reflects the average blood sugar level for the past 2 - 3 months; the poorer blood sugar control, the higher risk of diabetes complications
- Potassium - detects concentrations that are too high(hyperkalemia) or too low(hypokalemia); hyperkalemia may indicate kidney disease
- SGPT- ALT (Serum Glutamic-Pyruvic Transaminase - Alanine Aminotransferase) - give doctors important information about how well the liver is functioning and whether a disease, drug, or other problem is affecting it
- CYA C2 BY CMIA - monitors immunosuppresant/anti-rejection drug levels for management of organ transplant patients; levels below the range indicate lack of immunosuppresant drug dosage, higher than range numbers indicate drug over toxicity
The neph is positive that the increase in creatinine is not caused by rejection or infection because I am asymptomatic of both. No fevers, no edema, no decrease in urine output, no cough/colds, no pain in the graft area.
My anti-rejection drug range is 1000 - 1300 nanograms/milliliter. The table shows my CYA levels and Creatinine the past month:
CYA C2 nanograms/milliliter
Other possible causes of increased Creatinine are dehydration, diet excessive in protein and strenuous exercise. I take lots of water, my diet is well-balanced and my exercise consists only of toing and froing an 8-meter carport for 20 - 30 minutes on days when it's not raining. The task now is to identify what causes these irregular levels.
Therefore I'm in for more visits to the lab and neph this coming week. I'll do repeat Creatinine and BUN tests plus a Doppler Ultrasound of the Renal Graft on Tuesday. To further isolate the results, I was ordered to a low-protein diet and to stop exercising for the meantime.
Meanwhile, just to rule-out rejection, I am placed on a pulsed infusion of oral Prednisone, an increase from 20 to 60mg/day. If the test result still indicate a rising Creatinine level, I may be again confined so intravenous pulsing can be administered. Of course I wouldn't want that. Hopefully, it doesn't happen.
The journey continues.
Saturday, September 7, 2013
|Pre-transplant||2 Weeks Post-KT||Most Recent||Normal Range|
|Hemoglobin||10.2||9.7||11.9||12 - 16 g/dL|
|Potassium||6.20||5.20||4.20||3.5 - 5.10 mmol/L|
|Calcium||1.90||2.15||2.28||2.2 - 2.55 mmol/L|
|Creatitine||14.4||2.3||1.9||0.5 - 1.3 mg/dL|
|CYA C2 BY CMIA||366.5||994.1 ng/mL||Target: 1100|
Also, urine output is ideal with no traces of blood or proteinuria. Ninette, my beautiful, generous and ever-loving wife and donor, is doing great with all her test results within ideal levels. What I'm watching for now is on managing NODAT(New Onset of Diabetes after Transplantation). The neph said this will taper down slowly as the doses of steroids are reduced. I should also guard against weight gain and developing a moon-face.
Staying home and going out only once a week and only to see the doctor is not easy. You gotta find ways of killing time. I watch TV and DVD's, read novels and the paper, and dabble in social media. For exercise, a walking regimen, back and forth, using the length of the garage. When the wonlds(cholecystectomy and KT) have completely healed and I do not anymore feel the swelling and numbness in the area, I will setup my cycling trainer and start spinning again; something I haven't done in nearly a year. After another 45 - 50, days, and I shall be cleared to go out of the house and resume more regular activities. But to get back to work, the neph recommended another 4 months.
I would like to dedicate this next part of this post to everyone,; family, friends and friends of friends, colleagues, medical and hospital staff… everyone of you who supported us in this quest for a new life.
- The Jesuit community in Ateneo de Manila University and Xavier School, who offered our petitions during their masses; Fr. Ben Nebres who answered Ninette's 4:00am phone call and prayed with her at the time the doctors had to open me up again to evacuate the bleeding.
- The Ateneo and Xavier communities who included, and continue to include, us in the daily mass intentions.
- Frs. Ari Dy, and Johnny Go of the Society of Jesus.
- Ninette's colleagues and friends in from the Ateneo Math Department; Ninette's close friends: The 'Searchers'.
- Ninette's graduate students past and current; Fr. Eko Budi Santoso, SJ, who visited and prayed for and blessed me in the ICU and after.
- My Xavier School colleagues, especially the NExT Team for bearing some of the weight due to my absence and for the prayers.
- To my sister-in-law Pica, her daughter Lysyl, and Louren who travelled from Bacolod to be with us during the time when both Ninette and I were confined.
- To my sister-in-law Elgee, and Ben who helped us to do most of the hospital legwork and transactions during our confinement.
- My Kuya Noel, the De Las Peñas' in California who helped in prayers as well as the finances.
- The Nono's, my cousins for the moral support.
- The Peña's who spared some time out of their busy schedules to visit.
- Our UP friends Joey, Marian, and Agnes and all the others who have extended their support.
- Benny Lim and Xavier School Batch 2003... you surprise me. Thank you very much.
- The Coyiuto's and Revita's for their generosity.
- Facebook and Twitter friends from all over the world who flooded my timeline with prayer pledges and encouraging words; we were overwhelmed with all your responses.
- To Claudette, my caregiver, who took care of me from the time I was released from the ICU until being discharged.
- Our attending physicians who took, and continue to take very good care of us: Dr. Alberto Frederick Celestial IV, Nephrologist; Dr. Sergio Simangan, Transplant and Vascular Surgeon; Dr. Nelson Patron, Urology Surgeon; Drs. Dodee Niño Rigor and Rody Sy, Cardioligists; their fellows who respond to our immediate needs when the attendings are not available.
- The ICU and 3C nursing staff who displayed competence and professionalism as well as their genuine concern, warm smiles and soothing presence.
- To Robynne for the love.
- To Ninette with whom I will be forever grateful.
Thank you for all your prayers… singly and collectively, the most powerful reason I was able to pull through. Maraming Salamat po.