440) Need to Learn About Transplants?

March 29, 2013 

Friday

On PKD's Facebook page today:

PKD Challenge Day 29: Do you or someone you know have an upcoming kidney transplant? Visit www.kidneylink.org to learn the basics of kidney transplants and the kidney donation process.

439) Happy 4th Birthday Mordechai

March 9, 2013 

Saturday

An auspicious day, today!  Lizzie and I spent the day finding her the gold Honda CRV she has wanted for some time... and bought it! Went to her mom's for a delightful dinner.  And, I had a slice of coconut cream pie in celebration of that great day four years ago, when I was laid up in NAMC having my kidney transplant!

So,
Happy Birthday Mordechai! Four candles & one to grow on.  Thank you to my donor and Dr. Lewis, and Bernadette, and everyone else on that great transplant team (Dr Sankora, Rachel from NOLA, Mark the transport guy) and everyone on 4 North (Pauline from Kenya, Luvi, Jeffrey, Kristy, and all the rest); and John my son who came to spot Lizzie so she could go sleep.  Oh yeah, and Kim who said we HAD to name the little guy.

Onward Thru the Fog!

438) Annual Transplant Clinic Visit

March 8, 2013

Friday

North Austin Medical Center:  Regular clinic visit with hospital check-in taking 45 minutes (sorry we are running late Mr. Nowicki); Maxine checking weight (173); high blood pressure (160/77); and various Maxine stories.  Met the new Transplant Coordinator, Jessica, who took over for Patti, who didn't last long in this patient-focused clinic.  Jessica seems very nice, competent, and attentive as I explained my January bout with pneumonia and level of recent stress.

Dr. Lewis came in and we spent at least 10 to 15 minutes talking about current stressors (teaching my new class, getting a new ED at work, and losing Big Kim at work)  He was animatedly supportive.  When we got into his feeback on the Status of Jack & Mordechai  the Miracle Kidney, he said again, "you're doing GREAT!"  He went down his list of indicators for me:

• Creatinine 1.1
• Blood sugar 113 
• Colesterol 143
• HDB 5.6

He listened to my heart and lungs, felt my parathyroid, pressed on my kidney, and pronounced me good.  We discussed my idea of getting the shingles shot and he explained that since they put a live virus in you it isn't generally a good idea since I am on imuno-suppressants, but that we could check the (unknown) level at my next labs and that would give a better idea what to do.  

About the blood pressure increasing he wants me to try going back on some Norvasc in addition to the Linsopril and Normadyne that I am already taking.  I'll take my BP regularly and go in again in 4 weeks to check the BP.  Then my next appt will be in 4 months.

All in all a good report so I went away feeling a little less stressed and ready to wish Mordechai a happy birthday tomorrow.



 

437) Kidney Compared to Football

January 30, 2013

Tuesday

Had to post this from the PKD Facebook page:

The average healthy kidney is the size of a human fist – but the average polycystic kidney is often as big as an NFL football. Share the photo below with your friends to help raise PKD awareness!

436) Cancellation of TURP

November 16, 2012

Friday

Liz and I met with Dr. Bruce today for my pre-op meeting for the TURP scheduled for December 10th.  Liz was interested in reviewing my need for the TURP and I was interested in finding out more about why Dr. Bruce thought I needed a month of recuperation time afterwards.  

 Dr. Bruce started with a new drawing of my bladder and prostrate: this guy likes to draw, evidently. And he is quite good at describing things through illustrations. So, he gave us

the brief re-explanation of what was going on; adding more than last time... adding that the "median-lobe" of my prostrate was flopping over at times and that even though now-a-days they usually can do laser surgery, when there is a median-lobe situation they go back to the traditional form of surgery.   Liz asked if we still need to have the surgery if the original symptoms aren't continuing, and I reported that there is no longer any urgency about urination since I've been taking the Finasteride, and that I am not having as much frequency at night. 

We spent the next 30 minutes or so with Dr. Bruce doing a cost / benefit analysis of doing or not doing the TURP.  On the benefit side of doing the TURP, I stave off any possible recurrence of bladder stones, and there's less chance of pressure build-up in the bladder.  On the cost side of the TURP, my ejaculate will not include semen afterwards, and I will return to having the same chance any older man has of future prostrate cancer after stopping the Finasteride.  On the benefit side of not doing the surgery, I can keep taking Finasteride which lowers the chance of prostrate cancer, and will not have to have this surgery as long as my symptoms don't return.  So, that is good news.  We set another appointment for 6 months.

435) Video showing polycystic kidneys

August 30, 2012

Thursday

I ran onto this short news video today that shows a guy getting the "gift of life" from a co-worker... and, has a clip of some polycystic kidneys!  I think they look bigger than mine feel inside, but it gives you an idea of how they get enlarged.  

Here is the link:
http://wreg.com/2012/08/28/friends-brought-together-by-organ/

434) The Postponement of TURP

June 20, 2012

Thursday

Report:  My TURP "procedure" which was formerly scheduled for July 23rd is now scheduled for December 10th.  Here is the story.

Back in April (Post # 430) at our meeting with Dr. Bruce we found that he wants to do a trans-urethral resection of my prostate (TURP) to shave the prostate around the urethra to allow it to pass more urine more easily.  This is a fine idea in theory.  On our way out of the office we stop to meet with Becky to set an appointment for the surgery and select July 23rd because it is open on mine and Liz's calendars and because it is after I go back on Medicare.  We are as happy as the people on the cover of the Patient's Guide pictured here: we understand the operation; have decided it is a good idea to have one; and have selected a date for this overnight stay in the hospital for this procedure that will help me avoid future bladder stones, pee better, and such.


Back at work I add the July date to my calendar and leave several days afterwards for staying home to rest and recuperate and resume my work-a-day life.  On May 21st I am beginning to schedule things for late July and email Becky to find out if I am going to stay overnight at the hospital.  She checks with Dr. Bruce and emails me back, saying that "He does plan for you to stay at least one overnight.  Hopefully only one night."  I am fine with that and think to myself... "I also better leave a few days for resting up at home..." so I schedule a trip down to Wharton to do training for them for August 3rd.


By June 20th Liz and I have talked and she says, "The doctor said you have to stay home for some WEEKS to recuperate"  and I say, "Nah.  Becky says I'm only in hospital overnight..." and Liz shakes her head at me and tells me to get back in touch with them cause she remembers several weeks... So, I send Becky the following email:

"Becky ~ another question has popped up in a conversation with my wife last night.  She remembers that Dr. Bruce said something about ‘down’ time after the procedure.  I didn’t remember that at all and need to let my work know how much time I will be home recuperating.  Liz (wife) said she thought Dr. Bruce said something like 2 weeks.  I have an out of town trip for a training gig scheduled for August 3^rd, 10 days after the I go home.  And, unless I put time out of the office on my calendar, they are very likely to schedule other trainings for me to conduct.

"Please ask the Doc how long he wants me at home post procedure, and any other kinds of restrictions that may keep me from traveling (usually by car, but sometimes by air) or doing trainings (standing up and moving around for hours at a time).  Thanks in advance.  You have been very helpful so far.  Jack"

Well, this one has to move up the line to the nurse, who has to call me cause nurses don't really email people for some fairly obvious reasons. Nurse Joann calls me and clarifies that usually the home recuperation time is 2 to 3 weeks and it isn't a problem with lots of people because they're 'retired'!  I say that it will be a problem with me cause I work and didn't think it was that big a procedure.  She reports back that she'll ask the doctor and call me back.  She does and a couple days later she calls and says that Dr. Bruce wants me to stay home for 4 weeks post procedure cause I'm a transplantee and such.  I really can't remember exactly what all she said then cause I was SO freaked out about spending so much time away from work; and about the possibility of going stir-crazy sitting around the house all day long!


So, I generate the following parts of an email back to Becky; asking her to copy it and share with Joann and Dr. Bruce. 

"My training event in Wharton on August 3^rd (1 week & 3 days) is possible to re-schedule so that is not a problem.  However, I also have a major conference that my network presents in San Antonio for 4 days from August 14^th thru the 17^th.  This event I really cannot miss: it is 3 weeks & one day post surgery.  If I cannot be 100% (or, at least 89%) by then I will need to postpone the surgery.  Since finding out that the recuperation time is so long, I have done a lot of reading about this TURP and really have no symptoms right now that seem to make this an immediate need (such as having to get up at night to pee; feeling urgency during the day; or poor or interrupted flow) and I recall that when the doc and I discussed this we selected July because by then I will be back on Medicare.

And,  "My Fall semester of teaching at UT begins September 10^th and gets out on December 3^rd, and I have a month off til January 14^th, when Spring semester classes begin.  There is no way I can miss 4 weeks of class, since this graduate-level class only meets once a week."

On June 19th Joann calls me back and matter-of-factly says that I must stay home for one month post procedure, period.  So, there is the story of my postponement of TURP.  Liz seemed relieved, but truth-be-told, I am now concerned about being down and housebound during the holidays.  Oh Well.  Such is life.

433) In which Jack walks out before his appointment

May 30, 2012

Wednesday

Home:  Some notes about the last week: I had an appointment last Friday (the 25th) at NAMC to go in and have Doc Lewis look at my blood pressure chart I'd been keeping since my last clinic visit.  Well, I found out the appointment was on the 25th on the 24th, when Maxine called to remind me of the appointment.  I thought the appointment was scheduled on Tuesday, the 29th, after we returned from the first weekend of the Kerrville Folk Festival.


NAMC:  So... when I shot up to the clinic on Friday morning for my 10 o'clock appointment, I had to take Liz's mini-van cause my truck was full of watermelons to take to the KFF kitchen that morning.  I was early to NAMC and they told me I needed to get lab work (which I found out today was wrong).  I rushed to the lab and got my blood drawn and peed in a cup, then dashed on down to the Transplant clinic for my 10 a.m. appointment.

"We're running about 20 minutes late", I was told, so I went and got a blueberry scone and waited and waited and waited.  After 11 a.m. I finally decided I had to get those watermelons down to Kerrville, so I begged off my appointment and left my blood pressure charts (see image right) for Dr. Lewis to review.  I felt bad... but decided I had to leave because they were running way way later than ever before and I had watermelons to deliver. 


So, jump to today.  As I was considering emailing Patti she called me to report on Dr. Lewis' review of my charts... they look good to him so he wants me to stick right with my current meds schedule.  Creatinine is 1.3 and my cholesterol is 117 so all is good.


I explained my Friday story to Patti and she understood... and we went over the calendar for next visit... they have me on the calendar for July 24 and in the computer as July 20 (when I will be in El Paso doing training).  So, maybe these calendar differences are not all my ADD operating.  

I shared that I am going in for my shaving (TURP) on July 23 so we scheduled me for labs early on July 23, and they will find a way for Dr. Lewis to see me shortly after my procedure...  and let me know via phone or email.  So it goes!

In the News: Just heard this story on NPR ~~ "Trichakis and his colleagues decided to try to figure out how to balance fairness and efficiency in kidney transplants. They spent last summer building a sophisticated computer model that included thousands of variables and decades of data on organs and patients and medical outcomes.

At the end of the summer, they ran their model against the formula doctors currently use to allocate kidneys. Trichakis' model was just as fair as the current system— and enormously more efficient." Read the article  by clicking here: NPR Planet Money