Update + Gratitude

Day 43, post-transplant and I am feeling great. My weekly blood results show a remarkable improvement compared to when I was in dialysis and immediately after the transplant. Just to summarize some relevant numbers:

	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.

1. 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.
2. The Ateneo and Xavier communities who included, and continue to include, us in the daily mass intentions.
3. Frs. Ari Dy, and Johnny Go of the Society of Jesus.  
4. Ninette's colleagues and friends in from the Ateneo Math Department; Ninette's close friends: The 'Searchers'. 
5. 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.
6. My Xavier School colleagues, especially the NExT Team for bearing some of the weight due to my absence and for the prayers.
7. 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.
8. To my sister-in-law Elgee, and Ben who helped us to do most of the hospital legwork and transactions during our confinement.
9. My Kuya Noel, the De Las Peñas' in California who helped in prayers as well as the finances.
10. The Nono's, my cousins for the moral support.
11. The Peña's who spared some time out of their busy schedules to visit.
12. Our UP friends Joey, Marian, and Agnes and all the others who have extended their support.
13. Benny Lim and Xavier School Batch 2003... you surprise me. Thank you very much.
14. The Coyiuto's and Revita's for their generosity. 
15. 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.
16. To Claudette, my caregiver, who took care of me from the time I was released from the ICU until being discharged. 
17. 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. 
18. The ICU and 3C nursing staff who displayed competence and professionalism as well as their genuine concern, warm smiles and soothing presence. 
19. To Robynne for the love.
20. To Ninette with whom I will be forever grateful.       

This list is by no means complete. I might have missed someone. Please remind me. We'd like to express our appreciation to all of you.
    
Thank you for all your prayers… singly and collectively, the most powerful reason I was able to pull through. Maraming Salamat po.  

Photo credits:

sono-system.com

thefellowship.info

flickr.com/photos/roland 

Staff, Nurses and Techs

Going to a center twice a week and spending, on the average, about 6 hours for my hemodialysis has become a routine. On Wednesdays and Saturdays, I arrive at the NKTI Hemodialysis Center at around 4:30pm and after all the other routines, get to sit on the machine and be attended to by a nurse a little past 6:00pm. The routines include charging and paying for the session and purchasing the EPO from the hospital pharmacy on my part, and retrieving my dialyser, and prepping the machine on the part of the techs and nurses. A few entries back, I spoke about my classmates, dialysis patients who are in the same schedule and time slot as I am. For this post, I’d like to focus on these nurses and technicians who work with persons on dialysis who come to the NKTI Center.

It is a big, 24-hour in operation center. I’m sure I haven’t met all of the employees there. Well, these are some of them.

Let me start with reception. They receive patients and generate the charging forms, then retrieve the patient charts and tell the techs to fetch the dialyser from stowage. Sometimes they also change the seat covers to get the chairs ready for the next user. There is usually just 1 reception clerk on duty(at least during my time slot). And she(because all of them are female) controls entrance to the center. She makes sure that you have settled the charges for your current treatment session before handing you your patient card and letting you in to the hall. She also controls the sliding doors, pushing her button when someone wishes to enter. 

It’s a busy center so it is understandable the sometimes there are delays in reception. But sometimes, it also depends on who is on duty. There are clerks who take their sweet time and make you wait before they generate the forms, etc. There may be other duties that need to be done and they attend to them first. Some prioritize patients’ needs and makes sure you start your session as early as possible. They are very efficient and you actually feel their efficiency. Others lag behind a bit. Unless you are a new patient, they usually know your last name. Generally, they’re all okay. What I’d really like though, is for them to smile a little bit more, and not reflect the look of defeat and despair displayed by most of the patients.

The technicians retrieve the dialysers from their storage area and install them onto the machines. After your session, they also dismantle all the used tubes and dispose them into special trash bins. The also make sure that supplies are available by refilling/restocking AV fistula/graft and catheter kits, as well as dialysate, water and whatever else goes into the machine. They assist nurses by checking machines when they sound off their annoying alarms. Alarms go off when the sensitive machines detect low flow rate usually due to faulty AV fistulas/grafts or catheters, low dialysate/water levels, low/high patient blood pressure, etc. It is reassuring when a tech is nearby to check on your machine when this happens. The techs too, seem to be an efficient bunch.

Now come the nurses. This is the biggest group. There seem to be plenty of them on rotation. I’ve been going to that center for 2 months now and usually I see a nurse or 2 whom I have not seen before each time I enter the hall. But most of them I know by face or first names. They all seem efficient although some would really stand out. Greeting patients courteously and chatting them up is one of their strengths. One or two go doing their duties methodically/systematically, cleaning as they go. They care that the tubes and used syringes are properly disposed of unlike others who leave some of these trash exposed on the brims of the garbage bins. They take care of cleaning machines and even floors that after a few minutes, the area assigned to them is spick-and-span. Patients arrive in waves(due to similar session time slots) so sometimes you have to wait before you get attended to by a nurse. They hook up patients to their machines one at a time and close them up after, one at a time as well. Sometimes I overhear them chiding other patients jokingly about their take out fast food and snacks, and seriously about their pre-dialysis weights. Generally, they make you feel at home and cared for. 

There’s always a nephrology fellow around at all times. When s/he is not in the hall, s/he stays in a room next door. This doctor goes around patient to patient, checking for lung congestions and swelling legs/feet. They double check patient charts and machine settings. They also troubleshoot complicated closings especially bleeding fistulas/grafts and patients having cramps or having respiratory problems. They offer in-site consultation and write up prescriptions when you need it.  

It sure is a busy center, and it can get crazy sometimes. But I like going there. Most of the time, even if you only see half their faces, you know there are smiles beneath those masks.