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/

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!

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...

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).