Appointment With Transplant Surgeon
Today was my first outpatient follow up with the transplant surgeon.
I initially met with the Transplant Nurse, and she went over everything such as meds, labs, weight, BP, etc.
The surgeon came in, and overall was very pleased. He's very perfectionistic, and asked "what are we going to do about your weight?" But then he realized that my weight gain was mostly fluid, and he was OK with that when I explained that I had a 10 kg (22 lb) weight gain after surgery. He asked what the creatinine was, and said that "I want it lower". The nurse chimed in and said that she thought it was great, as did I. He said, "It's good, it's just that I'm impatient with these things". At first he was concerned about my urine, because the urinalysis showed small Esterace and large blood, which may signify infection. But I've had blood and esterace in my past few specimens, so that was reassuring. The culture is pending.
As for the rest of my labs, I was THRILLED with my creatinine; my kidney function last Thursday was 28% and is now 50%! My potassium is a little higher than even when I was on dialysis, but still normal; he just said that I should enjoy eating different foods, but in moderation. My magnesium is low, but he expected that; I'll be on a magnesium supplement (it was low due to my Prograf). My phosphorous is low, so I have to increase my dairy intake. Hemoglobin is low, but that's probably due to surgery; once my kidney settles in more and starts producing erythropoeitin, it should come up. I did have a large amount of microscopic blood in my urine, but again, probably a combination of the surgery and my "native" cyst-filled kidneys. My Prograf level will be back this afternoon. It was 3 when I left the hospital, and he wants it up between 8-10. I did have a dose increase on discharge, but I expect it to be raised again.
Appointment next Monday (every week for 3 months), as well as labs on Thursday this week and next Monday.
I asked about my fistula, since I was scheduled to have stents placed on Wednesday. He wants to wait 3 months and then have it done. He said that eventually, he will tie it off, but that's "a long way down the road". Since mine is a "high flow fistula", he said that he has seen where patients have gone into heart failure because of this. He convinced me....
Cross posted at WordPress
Lab
Reference Range
Value
Flag
BUN
6-20
27
H
Creatinine
0.7-1.5
1.6
H
Potassium
3.5-5.1
4.9
GFR
>60
50.2
L
Protein
6.0-8.3
5.8
L
Magnesium
1.4-2.8
1.3
L
Phosphorous
2.5-4.8
2.0
L
WBC
4.0-10.8
3.74
L
Hgb
14.0-16.5
10.5
L
Hct
40-47
32.6
L
FK-506 (Prograf
Pending
Blood, U/A
Neg
Large