413) Annual Transplant Clinic Appointment

February 24, 2011
Thursday

Preparation: To prepare for my annual clinic visit and evaluation I have to get extra blood work and do a 24 hour urine collection, which I schedule for a "Sunday" for obvious reasons. Maybe they aren't so obvious to you readers who don't have intimate relationships with the medical community, but all my pre and post transplant friends will understand... and will also probably find this next little story amusing.

On Super Bowl Sunday I woke up early and remembered that it was my day for my 24 hour urine collection. I had already found the collection bottle that the clinic gave me back in November, which was at the bottom of a pile of stuff in the back seat floor area of my truck; washed it out; and put it up on the back of the toilet for this procedure. So I peed, tightened the lid and carried my container and myself down stairs to breakfast. This bottle becomes your appendage for the day... so, you don't go to the park or out shopping, etc. I filled it throughout the day and superbowl and evening and night until the next morning; when I had to take it to the lab with me to turn it in and get my blood work. Well, the receptionist who usually checks me in says, "What're you doing here today? I don't have any paperwork on you..." and I stand there holding my brown paper grocery bag like a bomb... sure everyone knows exactly what it is rather than a bomb. She calls over to the transplant center for my paperwork and they reply that my appointment is NEXT Monday.

I sheepishly remove my brown paper grocery bag and myself back to my truck and back to the house, where I empty out the collection of my precious bodily fluid, wash out the bottle again, and hang it out on the back porch to dry. I try to think of it as a practice run.

This last Sunday I am ready again to collect urine for the lab! Same procedure... same brown paper grocery bag sitting carefully at my feet as I wait for the "check in" and lab work Monday morning. Peggy the lab tech laughs at my story.

One thing I noticed and later asked Dr. Lewis at my appointment this afternoon: Why is it that the first Sunday I collected the total amount was a little less than half the amount I collected this past Sunday? I mean... Super Bowl Sunday shoulda produced much more liquid, right? Dr. Lewis shared with me that urine output can fluctuate greatly on any specific day and it is normal for people to pee twice as much on some days and half as much on other days. Huh!

So, the report from the annual visit. First, my trusty scribe, Liz, wasn't there cause she is hosting her School Social Work Conference this week. I had to make my own notes! Secondly, Maxine the nurse didn't realize it is my annual so she starts with reminding me that my next visit will be my annual. I correct her and she is a bit flustered by that news. She rushes around in and out to get the necessary forms and annual questions ready. Takes my BP and it is 170 over something.

I recall to her a fight I had at the hospital registration desk cause I got here almost an hour early today, planning to check in, get some lunch, and read a journal. The check in guy forgot me and I sat waiting for most of that time. And my weight it up too. To 185! I am thinking, "Boy, they let me go to appointments every 3 months and things go down the drain..."

I nice pharmacy woman comes in to go over my meds and she still has the old list that changed since... we update and she makes notes of the way it is supposed to look. Then Bernadette comes in and we visit briefly and she lets me know that Dr. Lewis is 'on time' today.

Then he comes in and we shake hands and he gives me a once over physical prodding and looking at. I talk to him again about my hydrocele, which I don't think I previously mentioned on this blog. The hydrocele has been getting larger and we (Dr. Lewis and I) decided today to "drain the sac". It'll be a one-day procedure where he'll cut a small slice in the scrotal sac and drain the liquid and see if there is anything to do to ensure it doesn't recur. Chance of recurrence is about 20 to 30% based on my web research.

In looking at my lab results the doc reports that the kidney is fine. My 24 hour collection is used to check out filtering rate and it is excellent. My creatinine level is 1.3 which is good and the cyclosporine levels are good. He is concerned about why my myfortic level is low so he is adjusting those meds so I again need to take 2 twice a day rather than one and we'll check it in a month. Dr. Lewis is also concerned that my cholesterol and triglycerides are high and so he is upping my Crestor. These we'll also check in the next month.

And finally, the doc wants me to double up on my BP meds (linsolpril) and if I get too lightheaded I can either split the times or back off again. Bernadette asked me to do a BP log again and email her the results in a week or so.

So, there we have it. It is now almost two years post Mordechai's joining my other two kidneys and he is doing quite well. Now I need to stop celebrating and take care of my diet and other health concerns.