1. I was out the door shortly after 5:30 this morning for a drive to Sacred Heart for routine blood work in advance of my appointment at the transplant center, not only to be checked on, but to gladly submit to simple protocols associated with my one year transplant anniversary.
I made the drive to Spokane all the more enjoyable by listening to Jeff Harrison's May 8th Deadish program, archived at kepw.org. He played live music recorded by different artists on May 8th over the years, so I got to listen to Frank Zappa, Ten Years After, and the great acoustic duo of Jerry Garcia and Davie Grisman.
I would turn the drive back to Kellogg into a magic carpet ride with the phenomenal tunes Jeff played from the Grateful Dead's legendary May 8, 1977 show at Cornell University.
2. Today, I saw PA-C Natasha Barauskas. I saw her on my last visit to the transplant clinic in February and one other time and we are at ease with each other.
If you ever decide to have an organ transplant, among the chief concerns of your transplant team will be to prescribe you medicines that keep your immune system from rejecting the transplanted organ and, since such medicine weakens one's immune system, to prescribe other medicines that help prevent infection and protect you against certain viruses.
It's a little bit tricky.
Right now, the primary anti-rejection drug I take is Tacrolimus.
My system's response to this drug changes from time to time, so with every set of routine labs, there's a Tacrolimus test and the transplant team checks the level of Tacrolimus in my blood, looking for a high enough level of Tacrolimus in my system to prevent rejection while keeping the level low enough that my immune system is not overly compromised. So, from time to time, my dosage changes.
It's a balancing act.
Two viruses are of special concern. One is called the BK virus and the other is known as CMV.
I've been taking a prophylactic drug for a year now to protect my system against CMV.
Today, the PA-C, in agreement with Dr. Bieber, removed this medication from my pill box.
Going off of this medicine poses some risk, so I had more blood work done after this appointment and will have labs done once a week for the next four weeks to check the following:
- Is the virus known as CMV taking advantage of the medication change and appearing in my blood?
- Are there signs of any antibodies in my blood that could attack my transplanted organ?
- Are there any signs in my blood of a risk of my body rejecting the transplanted kidney?
- What is the health of the transplanted kidney? This test helps making this assessment without a biopsy.
After I answered a list of what things have I had or not had done recently, in keeping with the one year anniversary protocols, Natasha Barauskas ordered the following: a. bone density scan b. a chest X-ray c. an ultrasound of my native kidneys -- she told me my native kidneys are no longer functioning, but the ultra sound will provide an image of whether any growths or anything else untoward has sprung up on them.
OK.
More blood work once a week for a month.
Imaging.
Return to Dr Bieber on June 12.
I listened to music by Ten Years After.
This is what I have ahead of me one year after!
All of these procedures that lie ahead are important, but I thought the most important thing to come out of my appointment with Natasha Barauskas was her giving my condition an A+.
My transplanted kidney is filtering well, the protein in my urine has come down, my calcium is back in range, my blood pressure was great in the office today, consistent with my daily readings at home, my lower extremities are not retaining fluid, and so on.
I need to do all I can to bring my weight down and exercise regularly again to ward off the possibility of entering the pre-diabetes stage -- a common development for kidney transplant patients.
After Natasha Barauskas finished with me, I saw the pharmacist, dietician, scheduler, nurse coordinator, and social worker. I had especially helpful and buoyant conversations with the dietician and Helen, the social worker I've been in conversation with now for nearly eight years and who has been a great support and, when I wanted it, a comfort to me.
3. By the time I left the transplant center, went back to the hospital lab for the added blood work, and returned to the Camry, I'd been at Sacred Heart for six hours.
I decided the perfect response to being poked, questioned, examined, reported to, and told what to do would be a delicious beef sandwich on Dakota bread at Great Harvest followed by an oatmeal chocolate chip cookie with coffee. I was right.
I enjoyed this lunch, stopped at Costco in CdA for fuel, and headed back home, tired, but feeling good about what I learned, what lies ahead, and how I'm doing after one year with a transplanted kidney.
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