Happy Birthday

I turn 51 today. And I am starting it with an early morning, as in 6:00am, hemodialysis session at the center. My neph told me to move my session, which was originally scheduled Saturday nights, to Sunday, and the only available slot is 6:00am. This adjustment is made to prepare for the much anticipated kidney transplant procedure this coming Thursday, 25 July. For those who do not know, I am getting a new kidney courtesy of my lovely wife, Ninette. 

After the Ethics Committee approval two weeks ago, we were busy preparing for our double confinement. I'm sure it will be a management nightmare with both of us being in hospital. Hopefully, we will be able to pull it off with the help of some family and friends.

Tomorrow, I check in to hospital and begin my induction immunosuppression. By transplant day, I will have no immune system to decrease chances of rejection. Ninette, on the other hand, will check in a day before the procedure. I'm not sure if I'll be allowed visitors, but I'm not hopeful regarding that. Maybe one at a time, must wear a mask, and from a distance. 

I may be starting my birthday in the center, but this is one, if not the most, joyful of birthdays. 

Approved

Without any fanfare whatsoever, I received a call from the transplant coordinator whilst reading the action-packed Chapter 47 of Dan Brown's Inferno. Ninette(my lovely wife and willing donor) and I were in the lobby of the NKTI waiting to be called in for an interview by the Ethics Committee. One by one the prospective donors and recipients were called in to the conference room. I asked the staff in charge of cueing in the applicants when our turn will be. She said we were next in. So we waited in anticipation. We were ready and excited to meet and face the committee. We even power dressed for the event.

Then my phone rings… "Sir, You may now leave, the ethics committee has approved your transplant."

Weeks, months even, prior to this, Ninette and I underwent a series of tests to clear us for the transplant. We just need to undergo 1 more blood cross-match repeat test, and urinalysis and chest x-ray for me to rule out current infections. Then my admission to hospital will be on the 22nd; Ninette's will be the 24th. Procedure on the 25th. Of course this is barring any complication.

The next 2 weeks before my admission, I need to guard against infections and other illnesses. If I get even just a sore throat, all dates will be moved. Don't be surprised to see me always wearing mask. And If you see me without it, you have my permission to chide me. 

Family and friends' support have been keeping us positive. We thank you and ask for continued support even more in the weeks and months to come. Prayers have seen us through this and prayers will see us through more. Yesterday, I decided to drive up to Xavier School Nuvali along with Ninette and Byn(our niece/daughter). The 1.5-hour trip to the sprawling new Xavier School campus(I work in her main campus) located in Laguna was easy and enjoyable. Being a Sunday, traffic was light to and from. The main purpose was to visit the new chapel there; The Oratory of St. Francis Xavier, a.k.a. The Xavier Rock. A sort of pilgrimage to spend some quite time. I'm glad and thankful we did that.

Love - Hate Relationship

I have this Love-Hate relationship with my Permcath Hemodialysis access:

1. I love it because it is hidden underneath my shirt. People do not notice it unlike when i still had an IJ catheter at the base of my neck exposed for all the world to see. (There's a previous post here somewhere showing how it looks like.) 
2. I hate it because I cannot go topless even in a beach setting. I joined the company summer outing to a beautiful beach last week and I felt silly walking around with a shirt on.
3. I love it because it doesn't hamper movement too much; I can still walk and climb stairs, and swing my arms. Although I wish I could do more, like lift weights and do more intense exercise.
4. I hate it because the site becomes itchy especially around the adhesive that secures it in place. I don't mind the Tegaderm; it is quite comfortable. Try sticking a micropore tape on your upper chest and let it stay there for at least 3 days and you'll get the idea.
5. I hate it because it is difficult to get a decent bath/shower. Hell, I haven't had one since Feb. I cannot get the site wet since that will invite infection.
6. I hate it because I cannot go swimming. And swimming is like my overall favorite physical activity.
7. I hate it because I cannot perspire so as not to get the dressing wet. So I have to keep myself in check when exercising.
8. I hate it because most of the time, it acts up during HD sessions, that the machine's alarm goes off like crazy, that I seldom reach the desired flow rate the neph has ordered. And because of this, I'm scared that I am not getting enough dialysis.
9. I hate it because I have to go on another O.R. procedure tomorrow to get it repositioned. And this means another expense I'm not sure insurance will cover. That means another day off work.
10. I love it because it is my lifeline. So I have to take care of it. I've invested quite a lot to put this in, so I hope they will be able to correct it tomorrow and future HD sessions will be issue-free. 

I had another blood extraction yesterday to see how high my antibody count is. Hopefully it's not alarming. Perhaps this developed when I had the 4 units of blood transfused when I was confined last February. In hindsight, I think they should have done some processing of the blood first before the transfusion.

The HD staff again adjusted my dry weight a kilo lighter. I've been registering a low, even negative  weight gain pre dialysis. And because I'm not showing any signs of edema and loss of appetite, I guess the weight loss is good.

I'm happy for a 'classmate' of mine. She has passed all work-up procedures for her transplant. It's easier for her since her donor is her sister. They already have a scheduled date for the transplant. Good luck.

The PRA Specific Class I test results will come out after a week. Help me pray for a low PRA percentage. 

A Standing 8-Count

How do you react to something you have no control over? This is a question I ask now right after seeing my neph. I do not know how to react after some disturbing pre-transplant test results. These past weeks saw Ninette(my wife and prospective donor) and I doing lab blood work. These are very expensive blood tests not covered by health insurance. As I said previously, this is Stage 4 of a 5-stage process according to my neph. When we pass all stages, the transplant is a go. We've breezed through Stages 1 to 3 but now there's some snag.

The neph keeps a tabular record of all the tests we have undergone and all their results. Up until today, the space labelled 'Problem' remained empty. I had a positive reading in the PRA Class I antibody screening. PRA stands for Panel Reactive Antibody and is routinely done on patients awaiting organ transplantation. A positive means that I have anti-human antibodies in my blood. And, because of this, I have to undergo a deeper test called the PRA Specific Class I to determine the percentage of the population that the antibody in my blood reacts to. As well as compare it with Ninette's tissue typing and crossmatching results. Hopefully, I get a low percentage and probably the transplant can go on and I just will need a bombardment of modern immunosuppressants. If otherwise, then I am not a suitable recipient and Ninette cannot be my donor. Then it will be back to zero. 

So I gotta have this other blood work up. I asked about it, and the cost is quite staggering. But I gotta do it. Because, I admit it, the only thing that keeps me positive and going is the possibility of this transplant, and Ninette's love and generosity to give me a new lease on life. And since this is out of my control, I'm just gonna pray over this.

Some friends told me that my posts are very long. So let this be just a short one. 

What a scare

Image courtesy of emaxhealth.com

I visited Dr. Rody Sy, my cardiologist, last week. He told me to see him 3 weeks after my angioplasty. I’m happy to say that he gave me a clean bill of health from the cardiac standpoint. My next follow up with him is 6-8 weeks. He said if all goes well, he can give me clearance for the KT(kidney transplant). I just need to continue the meds he prescribed so as to make sure the stents in place will not get occluded. As I mentioned, I am on blood thinners, clopidogrel and Aspilet EC. And due to this, we cannot have the KT this early. Again, if all goes well, maybe July. Dr. Sy is such a kind-hearted man. I really appreciate everything that he has done and is doing for me. I wish I can repay his generosity one way or another. Even when I saw him last week, he looked under his desk to give me physician’s sample meds.

Since it could be possible that the KT will be in 3 months, I have to start with the work-ups again. About a month ago, I underwent an abdominal ultrasound and one of the results gave me some cause for concern. It said: Prostrate is enlarged with concretions. This was quite alarming, and I dilly-dallied on having it checked fearing the worse. Usually, men my age start to have enlarged prostrates and some develop cancer. To think that my mom passed on with cancer not 8 months ago. But, what the heck, I’m gonna do it anyway, so why not right now? So I went to NKTI and got inside the door of the first urologist’s clinic I found. 

I showed him my results. After telling me his interpretation of the same, he told me there will be 2 tests that I have to undergo. The first one was done right there at the clinic. He told me to drop my pants, and then gloved his hand. Oh my, a DRE! For those who do not now what DRE is, it’s the acronym for Digital-Rectal Exam. And I’m sure you now know what happened next. 

The other test is the PSA(Prostrate-Specific Antigen) Test. The test measures the blood level of PSA, a protein that is produced by the prostrate gland. The higher one’s PSA level, the more likely he has prostrate cancer. The urologist told me that if the result is normal PSA, then he can give clearance for the KT. So off to the laboratory I go. 

Yesterday before my dialysis session, I went to claim the result. And for a while, I was stunned. The paper I was holding said that the reference range for normal PSA is < 2 ng/mL, and my PSA level was at 2.440 ng/mL. Not knowing what it meant, I just sat there for a few minutes trying to decide how to feel. I texted Ninette(my wife) to ask her to go online to see what it meant. I couldn’t help but think that I, most probably, have prostrate cancer too... That I was not only on the big D but also have the big C. I became panicky and irritable waiting for Ninette’s reply. I also asked her, being a mathematician, if the symbol “ < “ is really the “less than” symbol. I couldn’t think straight. 

Then she replied: “...most doctors consider PSA levels less than 4.0 as normal.”

Whew! What a scare. During my dialysis session, the nephro fellow came and I showed her the result. She said, yes it is slightly elevated but she believes there’s nothing to worry about. It was only then that I started to relax. And after a few minutes, Dr. Celestial(my nephrologist) also came to see me. And I showed him the result as well. He believes my PSA is within normal levels for my age. He even said that the DRE right before blood extraction might have contributed in elevating my PSA. Whew again!

I went online to do some reading when I got home last night. And this table from zerocancer.org is one of the things I found.

Any day this coming week, I’m gonna see that urologist again and get that clearance. Well, I hope he does clear me. Hmmm, I don’t even remember his name. But I will never forget what he did to me.

     

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