I want a detailed documentation of my recovery from transplant surgery. This blog is where I keep a record of such things. If you are reading this, you might find it more detailed and, dare I say, tedious than you want to read. On the other hand, possibly you'll find it interesting. Here I go.
1. I was up shortly after 4:30 this morning going through my morning routine of emptying my catheter bag and charting my output overnight, weighing myself, taking my blood pressure, pulse, and temperature, and making a cup of coffee. Shortly after six, having packed up the blood pressure cuff, all my medicines, pill box, and our thick binder of information, instructions, and charts, Debbie and I piled into the Camry and drove to Spokane.
I checked in at the surgical lab on the fifth floor of the Providence Outpatient Health Center and a most friendly and concerned phlebotomist pulled a few vials of blood out of my arm.
Debbie and I had plenty of time in the downstairs lobby to eat breakfast. At around 8:20 I checked in at the transplant clinic where I had my temperature taken, got weighed, and had my blood pressure, pulse, and oxygen saturation measured.
After a bit, Dr. Khan, transplant nephrologist, strolled into the examination room.
He was ebullient.
A chief measure of kidney function is the level of creatinine in the blood.
My creatinine levels have come down significantly since I was admitted into the hospital on Saturday.
The new kidney is working.
Dr. Khan also loved hearing that I'm not in pain, that I am actively participating in tasks around the house, and that I'm not dependent on Debbie to do everything -- not by a long shot.
We also had a very good conversation about blood pressure. I'm at a stage known as "permissive hypertension". I came to this visit concerned that my systolic numbers have seemed high. Pre-transplant they would have been. But right now, higher blood pressure is a benefit to my new kidney and Dr. Khan is very pleased with my blood pressure numbers.
What a relief.
He was also very happy with the volume of urine I've been producing and determined that I no longer needed the catheter.
Having the catheter come out is a mixed blessing, in a way. Yes, it will be much better for my ease of getting around not to have to lug the catheter bag around the house, but the catheter also allowed me to sleep through the night since I didn't have to get up to go to the toilet.
Now, I'll be back to frequent visits to the bathroom during the day and all through the night.
For the next four weeks, I'll pee in a container to measure my output and record how much urine I'm producing over each 24 hour period.
Dr. Khan wants me to increase my fluid intake and work to produce clearer urine. If I do things right, I'll hit the fluids (coffee, milk, water, soup, juice, etc.) hard during the day and try to taper off starting at 5 p.m., with the hope that I won't be up and down so much at night if I reduce my intake later in the day.
Remarkably, I don't return to the clinic now until Wednesday, a very good indicator of how confident Dr. Khan is the progress of my recovery. I'll go to Spokane again on Monday for labs and will have labs drawn again on Wednesday before the Wednesday meeting with the transplant team.
2. After Dr. Khan consulted with me, I met my permanent transplant nurse coordinator, Jenn. She removed my catheter without incident, gave me a water bottle with instructions to hydrate so that I could urinate before I left. After I urinated, Jenn did an ultrasound scan of my bladder and the results were positive. I'm emptying it sufficiently.
Jenn talked with me at some length about what I must and must not do now that I've had this transplant.
Jenn was less strident about Copper than the nurse I talked with in the hospital who left me with the impression that I should avoid all contact with Copper.
Not so.
I can be in Copper's company and pet him, as long as I wash my hands afterward.
BUT, for the rest of my life, I am not to clean Copper's litter box and I'm to avoid being around litter box dust that Copper might stir up. (This is lousy news for Debbie -- and, when she travels later on, I'll need to recruit help with Copper's box.)
I have other restrictions: only very light lifting; no driving for about five weeks; I'm to stay out of the sun, but if I must be out, I'm to wear sunscreen, cover my arms and legs, and wear my wide-brimmed hat; I cannot return to vigorous exercise for three months.
Lastly, Nurse Jenn explained that the lab results for my Tacrolimus (anti-rejection drug) levels would arrive in the afternoon. Jenn called me this afternoon and instructed me to reduce my dosage of this drug.
3. Our third consultation was with the pharmacist who meticulously guided Debbie through the process of filling my pill box and reviewing what medicines I take when and the dosage. We pulled the stool softeners. We also pulled the two pain meds, neither of which I've needed or used. Dr. Khan added a medication to my regimen and Debbie dashed over to the hospital pharmacy and picked it up.
A couple final thoughts about these visits with the transplant team:
First, Nurse Jenn emphasized that because this transplant program is small, it's not only staffed by attentive professionals eager to be of help, it's also very flexible, an important fact if we ever run into problems being able to meet an appointment. The program only performs about 40-70 transplants a year. This is in stark contrast to the transplant program I originally enrolled in back in Baltimore. The staff is not inundated with patients and Nurse Jenn encouraged us to call in right away if any problems arise.
Second, Debbie and I were very happy with this visit to the lab and the clinic, much as we were very happy with my hospital stay.
With every conversation, we achieve a clearer understanding of what we need to do to advance my recovery, gain confidence, and know what to do to make our way through the next several crucial weeks.
Back home, Debbie went to Pinehurst Elementary School and worked with her students in the afternoon.
I had no problems taking care of myself and, when Debbie returned home, she fixed us a salmon and vegetable dinner. I complimented it with a bowl of fruit and yogurt and some cottage cheese and fresh pear. Our meal was in keeping with the dietician's recommendations.
We both hit the hay pretty early. I got rest, but not a lot of sleep.
I made frequent trips to the bathroom all through the night and twice filled the container for my output.
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