10/8/17

(453) Silicone Kidneys on the Horizon?

October 8, 2017  
Sunday

This morning I received an email from one of my colleagues (David Ray) asking if I had seen the new issue of Wired; specifically Megan Molteni's article on the future of implanting artificial kidneys.  Her article report the results of ongoing research, testing, and design work from the last 20 years and some of the funding history over those years.  

Now there is exciting news on the possibility of actually implanting an artificial kidney and people "signing up" for being considered when clinical trials begin in 2018 or thereabouts. 

Exciting Futures for folks on Dialysis!

5/1/17

452) Bouncing Around, Myfortic?

May 1, 2017
Monday

Since my last yearly follow up, seems my meds have been going haywire: especially the Myfortic dosage.  For years it was a stable dose.

Then it was too low so the doc went to three in the morning and three at night.  Too high.  So then I was at 2 in the morning and 1 at night.  Too low.  Today Mary from the clinic called and starting today I go to none tonight and tomorrow and then I start at 2 & 1 on even days and 1 & 1 on odd days

I asked her if Dr. Lewis knew why I can go for years with no real med changes and then it's all over the place.  She says he didn't say anything, and she tried to assure me by saying, "It's just changes with time".  

She doesn't know how I dislike changes!  Next lab work a week from today at 7:30 am at the same place as USUAL. Ahhhh.

So it goes.   

4/29/17

451) For those just reading this blog for the first time

April 29, 2017
 Saturday

I just posted a comment on the PKD Facebook page for someone who wished they had been able to read about someone's experiences pre and post transplant.  I commented that they could Google "Jack's Kidney Adventure".  Upon checking, I realized it has been ages since I put up anything about how to find the transplant point for a reader to use as a point of entry.

On the blog post lists one way to find the day of my kidney call, find 2009, March, Post # 337.  Or, you can just use the following link:

http://jakidney.blogspot.com/2009/03/336-in-which-jack-gets-kidney-call.html

3/9/17

450) In Which We Forget the 8th Anniversary

March 9, 2017
Thursday

So Liz, Shayna, Joan, and I are out to eat at Dogwood Cafe tonight and suddenly Liz remembers that today is the 8th Anniversary of my kidney transplant. 8 years! We all forgot.  The mark of integration of past crisis (or trauma) is integrating the event into the fabric of one's life in a way that it becomes one of the may threads that make up the tapestry of a life.

This is a good thing.  Mordechai the Miracle Kidney is now part of me.

The annual checkup with Dr. Lewis on February 28th went well for the most part: he called my kidney "a monster kidney" and he still wants me to follow up on a heart checkup that he recommended a year ago.  He wants an ultrasound on my abdomen.  And at the end of the meeting he asks me if everything is alright.

I, somewhat kiddingly say, "Yeah doc all is well.  But you know, whenever I press here (poking myself on the rim of my belly button) it hurts".  He has me back down on the able, tells me to arch my back, pokes my belly button and proclaims, "You have a belly button hernia".  "WHAT?" Liz and I say in unison. 
"Yeah" he replies.  A belly button hernia.  You need surgery. Go see Dr. Sankar; he'll do it."

The Rest of the Story:  Dr. Sankar is 8 years older than when he assisted on my transplant; still a friendly guy; and he gives me more info on the options.  We decide I will wait til after I get my heart checkup and take care of my HHT gum work.

  

 


9/15/16

449) Transplant Clinic Visit & HHT Report

September 13, 2016
Tuesday

Liz and I at the clinic for a 6-month check up.  Ran into Rodney in the waiting room: we are happy to see each other.  Its been awhile since I saw him here.  Its always exciting to see each other and congratulate each other; I think for still being around and healthy.  He and I got our transplants by Dr. Lewis the same day (or within a day or two of each other).

Also saw Maggie the Nephrology Social Worker in the waiting room and she gave a "hello". Now we are friends since she co-ordinated my training for the Nephrology Social Workers in April (see #448).  What a nice friendly clinic we seemed to have on this visit!

Maxine and Kim the nurse were there usual cheery selves.  De. Lewis reported that I still have a "kick ass kidney" and I thanked him again for giving it the thumbs up all those years ago when I was trying to figure out whether or not to take it.  He reported that my creatinine is 1.2 and all else looks good in my lab work. 

I showed Lewis my reports (CT chest angiogram w/ contrast, MR brain w/ & w/o contrast, and the CV echo of my ticker) from Dr Battaile, the HHT doc at UT Southwestern in Dallas and after some discussion and explanations about my heart's left atrium, we agreed that it wouldn't hurt to get a consult with a cardiologist here in Austin.  The result of all the testing in Dallas is that I do have HHT and we are now going to get a genetic test to find out which gene is marked so testing for the kids is cheaper.

Only other finding today is that Dr. Lewis want to up my Myfortic for a month and retest because it is a little off.  That's it until my next annual next April!  

As usual, Lizzie and I are happy and grateful as we drive off back to our work-a-day worlds.

Here is a link to a little PKD video I saw on Facebook for anyone who doesn't know a lot about PKD.  Oh.  And if you can spare some bucks, donate to the PKD Foundation soon.

 

4/8/16

448) Ethical Decision-Making workshop

April 8, 2016
Friday
 
I just have to post today, since I saw many of my old friends from El Milagro Dialysis at an ethics workshop that I presented for the Texas Nephrology Social Worker Conference at the St. David's North Austin Medical Center.

This was a fine group to do a workshop for and even though it was my first foray into ethical decision making for healthcare social workers, they said they liked the material and my enthusiasm.  

I hope to take the feedback from these expert and tenured medical social workers and integrate it into the packet to result in an even more sophisticated workshop to this specialty area of social workers.  I asked for and will still receive any and all feedback from any participants who may come up here to explore the blog so we can make the next edition of the handout even better. 



3/9/16

447) Annual Clinic Visit & Anniversary

March 9, 2016
Wednesday
 
Liz and I trekked up to the transplant clinic in north Austin yesterday morning for my annual exam with Dr. LewisOnce again, all is well with the miracle kidney.  Creatinine is at 1.2, BP is good, blood sugar a little high (but the same as every year) and all the other labs are good. 
Before Dr. Lewis came in, Maxine weighed me, asked the regular update questions and took my BP.  Then Kim the Nurse interviewed me about my medical issues for the last year looked at my EKG, and asked me about my difficulties with HHT over the holidays.  Given that gum crisis, she reported that my hemoglobin count was great, so I was glad to hear that.
Although Kim has been at the clinic only a little more that a year (she was new when were last there) she didn't know about this blog so we told her about it and she indicated she would check it out. 
As usual, I was very pleased to hear how well I continue to do so my last week's anxiety and grumpiness lifted and I am in gratitude about continuing to enjoy being on the planet.  


6/26/15

446) Video from Facebook

June 25, 2015 
Friday


I have been doing a lot more on Facebook in the last year or so and although I still check on this blog and am still considering how to update it to match my current lifestyle, once in awhile I find something that belongs up here where readers who check this can find information.  
This video is one that I really like and brings an important message to all who might be reading about PKD, dialysis, and transplants.

https://www.facebook.com/MikeHoskingBreakfast/videos/978806615486233/

Enjoy!


3/12/15

445) Happy 6th Anniversary of my Transplant

March 12, 2015
Thursday

The Birthday Dinner: This year we played it low key.  Did have Dale & Jan Yonkin over for Sunday dinner the day before the 9th.  That in itself was a wonderful re-uniting: Liz had never met Dale or Jan and we had a grand time telling stories and getting re-acquainted.  Will have to see them more regularly.


The Birthday of Mordechai the Miracle Kidney: Again low key.  My thoughts are that the first 5 years are monumental and deserve recognition.  Now I am thinking that 10 years, 15 years, and 25 years will be the BIG Birthdays to celebrate... kind of like wedding anniversaries.


Transplant Clinic Appointment: Liz & I went in for clinic visit on March 10th.  Dr. Lewis again reported that I am doing great! "You got a gang-buster kidney!".  Creatinine is perfect, etc. etc.  We are happy and I am relieved.  On the way home I realize that I always get quite anxious and edgy the week or so before my appointment.  Then, afterwards I am in a very good mood for days. 

For example, BP the next afternoon is 110/60.

Next blood work scheduled for June and next appt for March, 2016

Toast with Water!  Oh yeah, and today is World Kidney Day!


9/26/14

444) I Look Mahvelous

September 26, 2014 
Friday

Transplant Clinic Appointment: Liz & I went in to the new clinic (across the street from the Women's Center at St. Davids North) for our Fall visit with Dr. Lewis.  All was pretty much the same as usual: Maxine coming in and talking about various stuff as she set up the BP cuff and then Liz reminded my of dad's birthday coming up and my BP was 165 over something!

Maxine and Liz shut up and we waited a few minutes while I "relaxed" and then she took it again... down to 145 / 72.  So that was better, eh?  Then Kimberly from Boston comes in: she is my new nurse; Cindy has left and Kimberly and us spend some time getting to know each other as she reviews my meds list, etc.  Also tell Kimberly about recent annual physical, referral to Dr Hanschen for another colonoscopy and my 15 minute consult with him about if I really need another one since the last one was clear AND I thought he said I wouldn't have to need any more.  He went to check my records and they have been lost in the shuffle to put all paper online over the last year or so.  So we agree that I'll get another one and I told Kimberly that I haven't scheduled that yet.

Finally Dr. Lewis comes in and asks how I feel; says I "look great, better than most 67 year old's who haven't had a transplant".  He is concerned about a blotch on my forearm and referred me to his dermatology group for a screening.  Lewis reports that my creatinine is 1.2 and all else looks really good.  Has me jump up on the table and listens to me and pokes me around my lower abdomen, etc. and pronounces me in great shape. And, at some point HE does my BP and when he checks it, it is 122/70!

We are all happy about that.  He wants to see me again next March for my next annual.  So it goes! 

3/14/14

443) Annual Clinic Visit for 2014

March 14, 2014 
Friday

Transplant Clinic Appointment: Liz & I went for my annual clinic appointment this morning; got in with no waiting, and learned from Maxine that today will be a "nurses meeting" only cause Dr. Lewis has two transplants to do this morning.  I had seen him in his office as we walked by and noticed that he was in scrubs.

Maxine did her usual patter and BP (133/63) / temperature / gig.  Liz took a picture with her new "smart phone" of me sitting there waiting.  Maxine also caught us up on clinic changes: Jessica leaving to be a stay-mom with her new baby, and their adding Cindy from the Plano Transplant Center as the new nurse.

Since Dr. Lewis was not going to come in for his chart review and exam, Maxine also gave us the lab results, as follows:
  •  Creatinine 1.3
  •  Blood Sugar 113
  •  Colesterol 143
  •  HDL  38
Cindy came in and introduced herself and reviewed the chart and asked all the other more-medical questions like did I get a flu shot (yes), and aches and pains (no), swelling (no), abdominal pain (no), etc. etc.  She just moved here in the last 3 weeks and has found that rent and housing costs here seem higher than Dallas / Plano area.

So, basically all is great, as usual!  On the way out I poked my head in on Dr. Lewis and said "Hi... good luck on your transplants today" and he smiled and nodded quickly and turned back to his computer screen.  Next appt set for September.

PKD Walk ~ Our Page: Also of interest, we are again participating in the annual PKD Walk for A Cure this year, although not as conscientiously as we have in the past.  I did set up a donation page for any of you who want to donate.  I am asking for friends to simply donate $10 this year.  You can access my page at Jack & Liz's PKD Walk Donation Page  Thanks in advance to any of you readers who choose to donate.



3/10/14

442) In Which We Celebrate 5 Years with Relatives from Michigan

March 10, 2014 
Monday

Yesterday we had our little family birthday celebration for Mordechai the Miracle Kidney... 5 years old!  Yes, it was 5 years ago yesterday that I got my kidney transplant and for the first time we almost forgot the date.  We were sitting around on Saturday and at some point Liz remarked that this is close to the anniversary... and we hemmed and hawed around til I looked up the date on this blog.  Luckily, we hadn't missed it so we rushed around and added a little celebration to our already planned Sunday.

On Sunday we were already planning for entertaining my cousin Susan and her husband George from Michigan.  I hadn't seen Susan since I took Liz & Shayna to Michigan for my Aunt Marilyn's funeral back in 2008.  This is Susan's first trip to Texas so we had them up from San Antonio for the day; took them to see the capitol; and fed them green chile stew.  I am aware as I write this that at each anniversary we have had different groups of close friends over, and it felt just right to do this one with my closest relatives outside my immediate family.  

Susan and I spent a good piece of time hanging on the rail of the second floor of the capitol reminiscing about our early years at the Christi Lake cottage, all the changes and passings on of our moms, and her brother, and how important it is to keep that sense of "family" as we age ourselves.  Lots of memories shared later at the dinner table, along with the special perspective of George, who was older than Suz and I during those formative years, and brought his own perspective to memories of those times.

This was a perfect way for me to remember how fortunate we are to have family connection and to share gratitude for continuing to be on the planet.  I am curiously looking forward to whatever special kind of celebration happens a year from now on this auspicious date.

1/28/14

441) Announcement of Gettin' Ready for Transplant webinar

January 28, 2014   
Tuesday

Wow! It has been a lonnnnnnnnng time since I posted up here!  All is well with me and my Mordechai the Miracle Kidney!  On facebook today I got this announcement of a new webinar from PKD and wanted to give it a pass-along up here in blogland.

 
On PKD's Facebook page today: 
"What happens after you are told you need a kidney transplant? Melissa Blevins, RN, MS, will walk us through the process beginning when your physician tells you it is time to consider a kidney transplant. Learn more about what to look for in a transplant center, the medical professional team that will be answering your questions and helping you navigate the process, tests and evaluations required for transplant recipients and living donors, transplant costs, insurance coverage and much more. Transplant recipients will also share their experience and our expert panel will answer questions following the presentation."  The webinar will be on February 4rh.

If you are interested, sign up for this free webinar hosted by Melissa Blevins, RN, MS. Register here: www.pkdcure.org/learn/webinars-education 


3/29/13

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.

3/9/13

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.



 

1/29/13

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!

Thank you to everyone who participated in our poll yesterday. If you answered ‘Football’, you are correct! 

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!

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.