76) Phorgetting Phosphorus

November 22, 2006
Wednesday

Morning: Today I have to confess to Jennifer the Dietician that on Monday, when I told her I had taken my Sensipar last night, I was wrong. When I got home on Monday night and popped open my daily pill organizer to take my evening pills, I noticed that last night’s pills (sensipar and 2 others) were still in there. When I forget to take them, I only notice when I open the organizer box the next time… but for some reason I didn’t notice the next morning. At any rate, she had blood work done on Monday to check my phosphorous and it’ll probably be high, since I didn’t take the sensipar. Today she’ll come to me with my blood rating from Monday and we’ll have to have it out about my irresponsibility about taking my meds.

El Milagro: Heather stuck me today, politely asking if it was okay for her to stick me. She continued that she wouldn’t want any old stranger sticking her, and I replied, “Well, you seem to be okay… I’ll let you know if you screw it up.” She said she usually works at Moncrief’s DaVita center and is filling in here today for the folks out for T-day. Then she reported that she is Matt’s girlfriend and I had to say, “Oh, well that’s different. Now I’m not sure of the choices you make”; to which she retorts, “Yeah. Maybe I shouldn’t tell people that!”, and I decided she was okay. She stuck me pretty good although she wiggled the needle around somewhat to get a good flow, and that hurt.

Jennifer the Dietician came up and reported that my Phosphorous is getting better. I told her about not taking the Sensipar the night before, and she was a little surprised. We agreed to keep watch for another month before we decide to up the Sensipar by 30 mgs. Kim the Vietnamese Nurse (the first person who ever cannulated me) was standing there too, and she thinks I am taking a lot of Sensipar, as evidenced by her eyebrows arching up when Jennifer was talking about uping them.

Detailed Nutrition Report
Albumin ~ 3.8 (Goal = 4.8 or higher) This is my stored protein.
nPCR HD UKM ~ 1.27 (Goal = 1.0 or higher) This is my protein intake and calories.
HCT CALC ~ 36.6 (Goal = 33 or higher) This is my red blood cell count.
Iron Saturation ~ 49 (Goal = 20 – 50%) This is the amount of iron that maintains my red
blood cell count.
Ferritin ~ 146 (Goal = 100 – 800) This is my stored iron.
Calc. Crctd ~ 8.4 (Goal = 8.4 – 9.4) This is my calcium.
Phosphorus ~ 6.7 (Goal = 3.5 – 5.5) This is my phosphorus level, which is traditionally too high, although it is lowering; last time it was 7.7.
CaxPhos Crctd ~ 71.6 (Goal is less than 55) This is the calcium X phosphorus = product, which
is one way high phosphorus is not good for me and is controlled by binders and Sensipar.
PTH Intact ~ 421 (Goal is 150 – 300) This is my parathyroid hormone level which is helped by taking my binders and Sensipar.
Potassium ~ 4.6 (Goal = 3.5 – 5.5) This is my potassium level, which goes back and forth and right now is good.
KT/V UKM Delivered ~ 1.68 (Optimal is 1.4 or higher) This is the rating of the adequacy of the dialysis: how good it is doing at cleaning my blood.

Notes: In at 73.8 and out at 71.3 Kg.
The Nutrition Report is included for people like Tom T and my son, Johnny, who can read, understand, and are interested in these things.