1. Especially in these weeks immediately following the transplant, my prescription situation is a fluid situation. Right now, I take a daily baby aspirin, magnesium supplements, two anti-rejection pills and a steroid to treat inflammation (these are forever meds), a pill to prevent CMV infection, a blood pressure med, a soluble powder to reduce my blood's potassium level, and two meds I was taking before the transplant to reduce cholesterol and to treat my enlarged prostate. Every time I have labs, it's possible that the doctor(s) might make a change in dosage, take a prescription off my list (three went off this week, two permanently and one temporarily), or add something (this week it was the soluble potassium reducing powder).
So, one of my critical tasks as I move through my life with a transplanted kidney is to keep these changes straight and to maintain my pill box accurately.
It helps immensely that when I meet members of the transplant team, one team member who drops by is one of the clinic's pharmacists and she gives me an updated prescription list to put in my post-transplant binder. I immediately remove the outdated one.
Once in a while, though, I'm not absolutely sure what's what. For example, the new list the pharmacist gave me on Monday didn't include one of my meds and my After Visit Summary page, which lists changes in meds, didn't list this change and no one had mentioned this change to me verbally.
I reached out to Nurse Angela for clarification and, indeed, as long as my potassium level is high, Dr. Poudyal wanted me off the medicine that wasn't on my new list.
Luckily, when I have questions like this, the team responds in a timely manner so it was easy to get this minor problem straightened out.
It's imperative that I stay on top of my ever evolving meds list so that if something doesn't seem right, I can jump right on it and make sure I know what's going on.
After all, I'm an active and participating member of the transplant team, too!
2. I didn't mention in yesterday's post that because I'm a transplant patient, my prescriptions are managed by the specialty, not the general, pharmacy. On Monday, I enrolled in the specialty pharmacy's program to have my medications mailed to me at home. When I signed up for this complimentary service, Pharmacist Tracy told me to be sure to let the specialty pharmacy know when the doctor(s) discontinue any of my meds.
Once I confirmed that the prescription I wondered about in the paragraphs above was indeed temporarily suspended, I called the specialty pharmacy to inform them and I inquired about when I'd be receiving certain drugs that I'd be running low on next week.
The specialty pharmacy employee who fielded my questions was superb to talk with. She told me exactly when I could expect meds to be arriving and bolstered my confidence that if I'm ever confused about the delivery of my pills that the people in this program are eager to put my mind at ease.
Before too long, my prescription list will stabilize and a predictable mailing schedule will take shape.
Right now, things are in a bit of flux, but talking with the person at the pharmacy reassured me that my prescriptions are in the control of experts eager to provide superb service.
3. Shortly after noon Karlee, a transplant dietician called me, unexpectedly to check in on my eating habits.
I'd been hoping that one of my clinic visits would include an appointment with a program dietician because I'm doing my best to simultaneously raise the magnesium in my blood and lower the potassium.
Karlee asked me what I tend to eat for meals and snacks. She addressed my questions about magnesium and potassium. She put some information in the mail to further help me out.
I thoroughly enjoyed this conversation and it's much clearer to me now that to bring my potassium down, I need to cut out potatoes, oranges, and tomatoes, reduce my dairy intake, and limit my consumption of nuts. I can return to these foods once my potassium level comes down.
The HelloFresh pasta meal I prepared tonight included both tomato paste and a dairy sauce. I fixed Debbie's meal and included the dairy and tomato paste.
I made myself, however, an alternative pasta dish with Brussels sprouts and toasted panko and it was delicious and within the boundaries of what I need to be eating until my potassium stabilizes.
To sum things up: today made me very happy. My communications with all three Sacred Heart employees were golden. They were stimulating. They were reassuring. It buoys me that I am moving forward in my post-transplant life with a growing understanding of what I need to do and a growing confidence in my ability to follow through -- and that help is always just an e-message or a phone call away.
I'll fall back on a word I learned nearly fifty years ago.
It's empowering.
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