11/17/12

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 prostate: 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 prostate 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 prostate cancer after stopping the Finasteride.  On the benefit side of not doing the surgery, I can keep taking Finasteride which lowers the chance of prostate 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.


8/30/12

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/



6/22/12

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 3rd, 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 3rd (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 14th thru the 17th.  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 10th and gets out on December 3rd, and I have a month off til January 14th, 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.

5/30/12

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 

4/21/12

432) Transplant Clinic Appointment

April 20, 2012
Friday

South Austin Med Center:  I arrived at 7:30 am for my lab work and Hattie the lab tech reported that my regular tech, Peggy, has quit and moved back home to east Texas.  So, Hattie does my draw and then I head straight up to NAMC for clinic.  



NAMC: My first time to register without my Medicare 36 month post transplant status... now only on Liz's insurance... I have my checkbook in case there is a co-pay... but the woman who registers me hardly gives the change a glance as she types away and clears me for another clinic visit.


Since I am almost an hour early, I head to the cafeteria for coffee and grading a few papers before the appointment... and a person from the transplant center finds me and directs me back to the NAMC lab cause part of my earlier lab work wasn't done correctly.


By my appointment time I am situated in the clinic and Maxine tries to take a slower, longer time getting my BP; to no avail, it is still 174/80. Even though we all know I have "white coat hypertension" and Maxine usually takes it right after I sit down and while she is asking me questions, it has been worrying me that it seems to be creeping up over time.  I did mention it to Dr. Lewis several visits ago and he only seems moderately concerned.  Maxine runs me through all the usual questions for the form and I spend some time describing my recent bouts of hives: how they come on in the middle of the night, what they look like, how I decided to wait til after my Dr. Bruce referrals to call Dr. Krienke back about what to do next, and all about how I have been dealing with them over the last few weeks.

Patty, my new transplant coordinator, comes in with another new nurse (Pat) to discuss what Maxine has just written down and I repeat the whole story again, with the nurses talking about various ways to wash my sheets in Dreft and/or food alergies, etc.  Patty also asks about my BP monitoring and I admit that I haven't been tracking it as closely recently because of my neglectful nature and just having been focused on other things in my daily routine.  She makes me promise to get back on the schedule of checking it daily!


Finally Dr. Lewis comes in and asks me how my urination is going: pain? trouble starting? trouble ending?... to which I answer that all is as good as it was before the bladder stone and he replies about his talk with Dr. Bruce and how we should do the surgery and it is okay to wait til July and how he wants to know if it becomes any problem.


He continues that my cholesterol is doing so good that he wants me to drop my Crestor to 1/2 ever other day.  Creatinine is at 1.4 and every thing else looks good.  I tell him about my hives with the disclaimer that he shouldn't have to worry about that with all the important kidney and prostate stuff, and he counters with that I should leave it to him what he worries about.  


He wants to know all about the hives and suggests that I work through Dr. Krienke to get an appt with a dermatologist, or let them find one (although he admits that he doesn't personally know a good one to refer me to... and adding that HE will be studying up on hive himself in relation to this).  His recommendations are 1) get an appointment in the morning so there is at least a chance that I will have them when I go in; 2) Chart when I have them, including what I ate the night before; 3) Take pictures of them to show the dermatologist, and 4) Have the dermatologist send him the results.  He concluded that if they aren't caused by something external in the environment, then they are caused by something internal... and he wants to know about anything going on internally!


He wants to see me in 3 months... and then he leaves as usual, with a handshake and stating that the nurses will be back with appt info, etc.   About 4 minutes later he pops in again and says, "Your to number on your BP is too high.  I am adding another BP med and I want you to chart it and come in in one month with your chart... no blood work"  "Okay", I reply.  So, when the nurses come back in with my appointments, I find that he has added Labetalol, 100 mg, 2X a day.  Patti says I can take it along with my Lisinopril and if my BP gets too low (<110) then back off a little.

4/15/12

431) Adding Cluster Map

April 16, 2012
Sunday

For the first 4 or 5 years I wrote on this blog, I had a Map Widget that tracked the folks who visited my blog... by location and by operating system.  That widget finally went by the wayside and I can't remember if it became a thing I had to pay for or if it just bit the dust.


Today I added another widget for Cluster Map and I am quite excited about it!  So, now, again I can see who visits here and keep track of the locations of my visitors.

As always, thanks for your support and encouragement in my ongoing kidney transplant-related blog. 


4/11/12

430) Meeting with Dr. Bruce

April 9, 2012
Monday

Round Rock:  I drove up to Round Rock with Lizzie to meet with Dr. Bruce and get the consult from him on my earlier procedure.  Even tho we got there at 9 there was a line at his receptionist window and the woman working the window seemed to be taking her time with each person in the line.  I was thinking they should have a take-a-number system or something.  When it was my turn, she checked for my appointment, and gave me a specimen bottle, and I went about the business of filling it, even though I was pretty sure that the consult wasn't going to require that kind of testing contribution.  I wondered how many samples of unused urine they collect in a day.  Also, there were no paper towels in the restroom.  This office is not what I am used to in the way of medical offices, I thought... wondering if I was being to picky, they were just newly moved in, or if this was their usual pattern of behavior.


We waited... and I started reviewing a paper for School Social Work Journal.

An assistant brought us in to a treatment room and went about checking my BP while asking me questions, etc. and, of course, it was high: 160/80.  I complained to Liz after she left the room... "they never give me time to settle in, relax, and get a good reading...


Dr. Bruce came in and sat down with a pen and pad and said, "I want to draw you a picture."  He drew and explained that this situation is like a pond that fills with water and then can't drain completely... (which he had said last week too) and this time he added, "so when it can't drain completely cause of the prostate squeezing, bladder stones develop".  OH!


He described that they want to do an operation... I asked about a stent... and he replied that they usually don't do stents for young guys; only older people... and that made me feel young.  We brought up my deal with Medicare and discussed doing this operation in July, after I get back on Medicare.  He thought that was fine; and added that he still has to talk to Dr. Lewis about it all.  


So, I have another appointment with the Transplant Clinic this upcoming Friday... and this saga will continue.  Looks like there'll be a trans-urethral resection of my prostate (TURP) in the summer sometime.

4/6/12

429) No Pain, No Gain is the Only Way I can Positively Reframe...

ALERT: Graphic content intended only for patients who want to know more about these procedures.

April 5, 2012
Thursday

Round Rock:  I drove up to the Round Rock office of Dr. Grady Bruce early... straight from UT after class.  I was scheduled for a cyctometrogram and uroflow study with Tracy, and according to Dr. Lewis, who surprise-called me on my cell phone as I was driving back from Houston last Friday, Dr. Bruce is gonna stop in and see me while I'm there. 

First thing: I have to report to the receptionist that I am no longer on my 36 month post-transplant Medicare and that Liz's insurance is covering this.  She calls and they tell her I am on Medicare and then after some back-and-forth, they tell her this procedure is 100% covered... not even a co-pay.  That pleases me.  However, Dr. Bruce is aw ay "on call" somewhere and won't be back til 6.  But, the 1:00 appointment no-showed so Tracy will be with me shortly.  This I find out in response to my statement to the receptionist that I gotta urinate now and should I go or wait?  Wait.

So, Tracy comes out and brings me back to a room with a barber style chair with stirrups and tells me to go into a adjacent bathroom, strip from the waist down and urinate into a large funnel sitting over a small beaker with a little grey tube leading outa the room and into the treatment room.  I am thinking this is easy.  I pee into the funnel and they somehow measure the "flow" in the little grey tube.  Then we talk about it and that's that. I do so and put on a gown backwards and return to the barber chair room, where Tracy introduces me to Dr. Etsen Cho, who is going to observe and learn from my experience.

Oh.  And, I hear from back somewhere that Dr. Bruce is back from his "on call" and available.  That's good. 
Well... there's a reason they don't tell you to much about cyctometrograms like they do with most "procedures" we patients volunteer for.  You know: they usually have a nurse call and completely explain and give info about the procedure before you go in.  Not in this one.  And, I had been so busy in the last week or so that I hadn't even googled it.
Tracy invites me to sit in the chair and sets about catheterizing my penis!  Oh. And, Oww! And "This stings!"  Tracy asks me to breathe in through my nose, out thru my mouth... slowly... as she continues to try to run this catheter up my penis, through the prostate-squeezed urethra and into the upper part of the bladder.  She is explaining to Etsen how she will try another size (?) or something while I am trying to breathe thru the pain of each of her attempts.  No pain for the time it takes her to re-adjust her tools.  That's nice and I breathe better. She apologizes for the pain... and we are off on it again.  I breathe they way she suggests, harder and more forceful... she pushes that thing up there... and I am conscious of clenching my teeth so hard I worry I'll break one... and I can feel tears rolling outa the sides of my eyes and back down my face towards my ears.  This is tough! 


She pulls the catheter back out and says something like, "It's just to small an opening... I can't get it through... will have to get Dr. Bruce in to try."  I breathe / sigh / relax.  The women leave the room and I lay back and visualize how I can dissociate when they resume this procedure.  


Tracy and Etsen return and we are talking about my years on dialysis, the kidney transplant, my teaching at UT, ..Macs versus PC's, and how this whole thing started:  I thought I had a urinary tract infection and went to Dr. Krienke, who did a culture that showed it was not an infection and then about calling the Transplant Center when the painful urination continued... and about the hosptialization and yada yada yada.  

Dr. Bruce finally comes in as I am finishing with Dr. Krienke and his referral to Dr. Floyd for me and Bruce says Floyd is part of his practice... and comments that I must have had my share of experiences with doctors... He sets about asking Tracy some technical questions and expertly inserts the catheter again (more of the same pain) while saying "We have some tricks..." and in it goes, with him concluding, "I think it's in... it's not getting shoved back out..." and I am breathing out and sensing that even though it is somewhat uncomfortable it is not painful at this point and I know I can handle it from here on out!


He says that now Tracy will continue the flow test and he will study the results, call Dr. Lewis, and meet with me as soon as he can to fill me in too.  Tracy brings out the funnel and jar contraption and sets in front of my chair.  I have these tubes up my penis and she describes that at some point I will either sit and urinate or stand up in front of the funnel and urinate into it, while the machine measures the "flow" and pressures on my urethra and my sphincter.  Tracy continues; explaining to Etsen what she will be seeing on the graphic display and instructing me on what will be happening too.  

Long story short: They fill my bladder with a solution and want to know when I first can feel the cool liquid in there; then when I first feel like I want to urinate but wouldn't normally go to the bathroom; then when I begin to think I might want to go to the bathroom; and then when I it is time to go to the bathroom; and "Now I want you to wait til you can't wait anymore..." Tracy concludes.  We talk some more about trivial stuff (her going to UTA, marriage and family counseling, respecting our elders, etc.) while I continue to hold it as long as I can.  She tells me that if I feel that I cannot urinate with two women in the room, I can ask them to leave right at the last moment.  I am wondering how this all will happen and envisioning if indeed I will be jumping up to pee and yelling for them to get out... don't imagine that will happen when the time comes.


We talk and just enjoy our visit until I can't hold it any more... and I stand up, holding my tubes and all, and relieve myself over the funnel ("Ahhh") as the women watch the measurement graphs charting my performance!  What a scene!  With all those tubes up there I have to concentrate to ensure it all goes into the funnel.  Then Tracy asks how that is like usual and I (without even thinking of that absurdity of that question) report that I didn't feel like the flow was a forceful as usual when I feel this kind of urgency to urinate.  I add that I think the tubes up there may have impacted the normalcy of my gushing flow... or something to that effect.  Tracy considers that and nods that that reflection might have some merit... also saying to Etsen that my flow seemed, on the graphing display, to be less than a normal flow.  I, in my mind, agreed... and yet the part of me that is happy this is over doesn't really care at this point about the findings.  I just don't want them to say, "We gotta do it again...


Tracy concludes that we are done for now.  She simply slides them tubes out and I get dressed.   As a kind of debriefing gesture, I ask Etsen if her name means anything special in her culture (she is from Camaroon) and she replies that it means 'hut' and was her grandmother's name.  Tracy comments that she loves ethnic names and we are all smiles as we say our goodbyes.  "What a day" I think to myself as I drive away towards the south.

3/24/12

428) Another Hospital Stay

March 21, 2012
Wednesday


Checked in at NAMC at 2:30 pm, after working for a couple hours.  A couple of interesting things during prep... my anesthesiologist found some irregularity in my EKG
and showed me my EKG charted, pointing out the abnormality... a slight dip right before one of the spikes... The tech was able to find an EKG from 2009 that looked exactly the same, so the anesthesiologist felt better about approving the surgery.  

She also questioned how long it had been since I'd had my thyroid meds checked, since my thyroid function today is about 7.2 where it is supposed to be 6.  I told her that I am not even completely sure who the doc was who originally put my on synthroid, but that I know that it was checked back when I had hyper-parathyroid problems in September, 2010, and Dr. Moore checked it.  She was surprised that that Dr. Moore told me to take one synthroid a week out of my dosage way back (see Post #402).  She recommends that I go back to taking it everyday and get a thyroid test in the near future to update my synthroid. 

By 5 pm they finally took me down to the operating room for the procedure and all I remember about that was rolling into the operating room and moving over to the table.  Then I was waking up and very hazy as Dr. Lewis explained that my stone was actually a BLADDER stone, not a kidney stone!  He showed blurry me a pic on his I-phone of this black rock that looked to me like a meteorite beside a ruler on a field of blue... 1.1 centimeters (similar to the picture I made here).

This evidently means something but I am just waking up so I only know that there is an important fact or idea out there floating around and there is no way I am going to catch it at the moment.  I return to dozing off and on for some time and at about 8 pm I am awake enough to realize we are not going home tonight.  Liz is staying here overnight; John is staying with Shayna; and I am aware that I am not going to do my training in New Braunfels tomorrow morning.

I am moved from recovery to a room back on 4th floor (again) where Monette is my nurse overnight.  I don't need any pain meds and seemingly am urinating without pain throughout the night.  Early the next morning Dr. Lewis comes in to check on me: irrigates my bladder and the liquid looks clear and not too pink.  He wants an x-ray of the bladder with and without contrast and then one of my peeing the contrast out to ensure that there were no tears or nicks when he dragged the stone out.  He explained that he couldn't break it up so just had to drag it out.  Thru the day I feel okay and am up and around in my room.

At 2:30 pm I am wheelchaired down to radiology where Alan the tech gets me prepared for this procedure, explaining that the prep takes way more time than the actual test.  Alan and I get to talking about various medical topics, including cost of treatments, insurance, social work, dialysis and diet.  He is married to a social worker over at MHMR and they are vegans... etc.  The supervising doc is Dr. Michel, a pretty redhead who expertly guides me thru the test: we shoot in the dye, let my bladder fill up while I watch on a video screen. Then she pulls the plug on my catheter and it drains a bit.  Dr. Michel goes off to check the x-ray shots on her computer and Alan and I watch them line up on the screen like a slide show, get 'em all correctly contrasted for the best silouette views, and numbered and labeled and I watch.  These shots remind me of pics of egg sacs of Black Widow spiders. Then they move the x-ray table up to an almost standing and direct me to pee the rest out into a collection jar.

Well, guess what?  It ain't easy to pee in front of a pretty redhead... even tho she is a doctor.  So she shoots outa there back to her office and Alan and I talk while he fills me up with cups of water (about 6 or 7) and I try to relax enough to do the job!  I'm semi-standing there between a hard steel bed and an x-ray machine leaning on it with my left elbow... like being in a water bar yacking with a guy... and sooner or later I know I'm gonna hafta pee.  Alan is asking me about the people I met in dialysis... how many worked versus those who were completely disabled by their condition...

And suddenly I gotta PEE! Alan rushes off to get the doc and I grab the head of my penis and squeeze hard to keep it from exploding before we can get the pics.  Dr. Michel gets there, maneuvers the x-ray machine around to get the clearest view possible and I let go.

She gets the shot and goes back to check the views on her computer while Alan and I wait... Alan  exclaims, "Wow; that was so cool to see your urethra bulging up like that and then when you let go it just whooshed out!" I had missed that on the screen unfortunately, since I was the actor holding the bulge... but I shared his elation at that observation.  Mostly, I was happy it was over and I had performed the function adequately.  


So, it was back to my room to wait for the results.  Before I left radiology, Dr. Michel shared with me that it all looked good from her perspective.  Later Dr. Lewis came up and had a final report and prescription for me.  All the tests look good to go!  He is prescribing Proscar for me to help with shrinking my enlarged prostrate.  He sees no sign of cancer, thank God.  He referred me to a Dr. Bruce for a cyctometrogram and uroflow study and  set an appointment for his own followup in a couple weeks.  But, he concluded, my prostrate will continue to get bigger  and he will eventually want to go in there again to "shave it" at some point.  Oh boy, I thought.


Paul the day nurse, who looks like an Asian Paul the Beatle (from the "Meet the Beatles" album cover), came in to unhook my"I drip and complete my discharge paper work, and give me a pneumonia shot (which will last 5 years).   "Is this one of those that'll be painful?" I inquired and he smiled and replied, "Oh yeah!  For a couple days..."

Great.  It couldn't be worse than the pain I've had in the last few I thought.


Note: More info at http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/

3/21/12

427) In which Jack's Pink Urine is Studied

March 20, 2012
Tuesday


Early this morning I called Patti, the new transplant coordinator... since Bernadette has moved up to a higher position.  I left Patti a message to call me and then tried Bernadette's phone.  She answered and I explained to her about my burning urination, going to see Dr. Krienke last Wednesday, getting a culture done, and how my urine started getting pink last night around midnight.  This morning its murky red and still burning to urinate.


She recommends I find out about the culture and then call her back... so, I called Krienke's nurse, who, after some hemming and hawing (Krienke is on vacation), reports the results were negative and she will fax them right over to the transplant clinic.  I call Bernadette back and leave her a message.


Later Bernadette calls me back and tells me to come in to the clinic right now; sign in, get labs done, get an ultrasound, and come over to see Dr. Lewis.


At the Clinic
After these tasks I get to the transplant clinic, where Maxine takes my BP and it is 190/86 and I know that is really not accurate since she is talking to me and asking me questions throughout the measure.  Then Patti the Nurse and new Transplant Supervisor comes in to hear "the story" one more time, check my list of BPs I've been keeping and comment that they look good and "see how it goes down when you are doing yardwork?",... and then, Dr. Lewis gets to hear the story.  He takes my BP and it is really 155/72.  He pokes and prods me and decides I need a CT scan before he make his diagnosis.


Jump to Conclusion
Before going for my CT at 2 pm, Nicole shows Patti how to do an ultrasound of my bladder... and then drink a lot of water and then do another one and they measure the difference... not much difference.  Of course, after I leave for the CT unit, I pee all the way...

I meet Gayle, the CT scan tech and we talk about socialized medicine, waiting times, and how many docs send people for CT's unnecessarily (according to a tech) and then I traipse back to the clinic where I wait for the CT results...


I have a 1.1 centimeter kidney stone that has moved out of my kidney, down to my bladder and it didn't 'kill' me with pain cause  Mordechai has no nerves attached... smart on the doc's part.  Now it is in my bladder and Lewis thinks it is too big for me to pass naturally so tomorrow I will come in and he'll do a cycstoscopy.  And as long as he is in there, he'll also possibly do a bilateral urethral pylogram, a transurethral bladder biopsy, and maybe even a cystolitlplexy!  I have little idea what all this is, but I did get Patti to write it down on some nurse stationary (ala paper towels) for me to look up on google.


More to come!

3/9/12

426) Annual Post-transplant Meeting

March 9, 2012
Friday

NAMC:  Before appointment with Dr. Lewis Liz and I met with David the social worker to discuss Medicare, Liz's insurance, and planning for re-applying for Medicare in July.  David looked thru my record and the three year anniversary is today, not tomorrow.  According to David they count the date as when they first cut you open, not when you wake up.  

So, Happy Birthday Mordechai the Miracle Kidney!  Three years old today! David helped us by explaining all the details about Medicare parts A, B, C, and D; Medigap, and everything else we need to know to make an informed plan for July.  And then we headed over to meet with Dr. Lewis. 

Maxine came in to check my vitals and my BP was way high... checked again little later and it was down to 150/80... but still way higher than when I check it at home.  Maybe the coffee I drank while waiting for this appt.  She left and the new coordinator, Patty came in and introduced herself and shared that "RN" stands for "registered nag" and she nagged me about exercise and drinking plenty of water.  She did say, upon looking at the data, that the fact that I turned in 1300 ml of urine from my 24-hour collection last Sunday suggests that I am drinking a good amount of water.  She remarked that I should be drinking 200 liters a day.  She also reported that my Creatinine was 1.3 and that my glucose was 131, which is a bit high but okay since I wasn't fasting before I went in for Labs last Monday.  So, her verdict:
1) drink 200 liters of water a day, and
2) walk at a brisk pace for 20 minutes a day.


Dr. Lewis came in and shared that "you look the best I have ever seen you." to which I said something like; "you always say that"; to which he replied, "no. I mean really.  You look great!  Your creatinine is good, your cholesterol is low, and you really look good."  


He is lowering my Crestor from 1 & 1/2 to 1/2 a day!  Wants to check it in 4 weeks.  Talked to me a little about my BP and asked that I take it daily for awhile... and we made another appointment for 4 months.  Liz and I were delighted about the feedback.  So it goes...


3/8/12

425) Three years When?

March 8, 2012
Thursday

So, last night Lizzie and I are laying in bed and she is wishing Mordechi the Miracle Kidney a happy birthday... and we are puzzling thru what the actual date was.  It was Purim, but that follows the Jewish calendar so that is no help.  She thinks it was on March 6... I say March 8.  What WAS the date?  So, today I am up here on the blog finding out that the date was actually March 10th!

Three years ago this Saturday I had a kidney transplant!  It is long enough ago that we can't remember the DATE!  That's history!

So, how am I doing?  My annual Transplant Center appointment is tomorrow morning.  I did NOT get a call from Bernadette about my lab results from Monday... so, that is a good sign that all is okay.  I get worried, now that I only go in every 6 months... worried that we something will go wrong and we won't know about it for too long.

And, I come off my 36 months post-transplant Medicare... so Uncle Sam thinks I am good to go, I guess.  We meet with David the Social Worker tomorrow to figure that stuff out.  Of course I can sign up for Medicare in July, when I turn 65... so that won't be too many months of higher payments for stuff.

I'll post a post-transplant center visit posting to report on how I am really doing (medically speaking that is).