Saturday, November 2, 2013

Three Month Mark

         Started the new med today.
   These buggers are as big as they look.

Friday, November 1, 2013

Ch..Ch..Ch..Changes.....

October went out with yet another change in meds as directed by Dr. Yang at clinic yesterday.

It's sorta-kinda big because it's one of the magic three immunosuppressants that make up the "magic cocktail" that they don't fool with too much. The doc wants me to switch from Progaf to Neoral which he says should reduce the tremors that I have by a whopping 50%. 

Hmmmm.
I'm keeping an open mind.

They've also cut back on another drug and added some more new ones.

Such is life after transplant.
I mean somebody has to support these drug companies. 
(No offense to all the Pfizer folks in my family.) I am very  grateful for the medications and what they do for me.

Even with these changes, the tx team is happy with my progress. They took 8 tubes of blood for more tests yesterday and Dr. Yang made it a big point to tell me just how great my creatinine, BUN, glucose, amylase and lipase levels, among others, are.

They want to see me back at clinic in two weeks.

Tomorrow is my three month mark and despite my occasional grumbling about the side effects, I am a heck of a lot better than I was three months before the surgery. 
And I am forever thankful for that.

Thanks for checking here.

Tuesday, October 22, 2013

Ice in my veins....

Sorry Laura!
I did kinda leave that hanging! 

The Cytogam IV went well for the most part last Friday. It just took a little longer than the usual 3 hours because 2 hours into things I got a wicked case of the chills.
A kind of "rattle you out of your skin" chills. The nurse sussed it out pretty quickly and took my vitals and unhooked me from the IV. I tried to persuade her that all the shaking was just me bouncing my leg (which I do.)
She didn't buy it. 
So I then I apologized for keeping my house so cool.
She saw through that like a cheap suprise.
Then I tried: "Well I DO have tremors!"
Un Uh......Nope......No way.
She responded by asking me how close EMS was. 
She wanted me to lay down and cover up but I got her to settle for me putting on a sweatshirt and having a cup of hot tea.

Over the next 45 minutes the nurse took my vitals 5 times asking me questions the whole time. After the 45 minutes or so....the tea worked or least that's what I tried to sell. She said it was the current absence of Cytogam and then after a dozen more questions, she restarted the IV at a much slower rate. Nurse Barb tells me that this is one of a myriad of side effects that are possible with Cytogam. She was just super happy that it didn't progress to anything else.

I did have chills (not quite to this extent) at the end of the first treatment, but I wrote it off and persuaded the nurse that it was nothing. She made note of it and let it go.
This nurse Barb (the first nurse was named Barb as well) was a real stickler for every detail.

Afterwards, I was fine. My Dad came to visit later in the afternoon and we had a great weekend. 

So all is well that ends well.

Final installment of Cytogam is slated for November 15th and then I'll be done with this noise.

Thanks for checking Laura!

More soon.

Thursday, October 17, 2013

Whole lotta' shaking going on......

Not a whole lot to report this week.....my blood labs from Monday were all acceptable.
We'll see what today's lab results are tomorrow. The people at the local annex all know me by name now because they've seen me at least twice a week for weeks now ...how sad is that ?

Tomorrow, the nurse from Coram comes to give me my second 3 hour IV of Cytogam.
Hopefully all of that will go well again.

My next official clinic appointment isn't until October 31st so I'm hoping for a treat (maybe in the form of a med change to get rid of these tremors) and no tricks.

That's all I got for now.

Thanks for checking here.

Saturday, October 12, 2013

It's funny when things change so much... It's all state of mind

Things got a little interesting this week as I changed one of my main immunosuppressant drugs from CellCept to Myfortic as I had posted earlier. 
Myfortic is a slight derivation of CellCept but supposedly without some of the nasty side effects, so far this seems to be pretty much the case. Not total absolution of side effects, but definitely less.

The other item of interest was the call I got this week from the tx center as it seems word had gotten back to Dr. Yang that I was not totally down with his quick dismissal of the tremors for an additional 3-4 months. The good doctor wanted me to come up and see him Thursday morning so he could explain things a bit more succinctly, which he did. 

What I hadn't realized to the fullest extent was just how wigged out the whole team had been about the one, brief, episode of rejection that put me back in the hospital at the end of August. Evidently such sudden episodes aren't quite the norm so early in the immediate post hospital days.
At the time, it seemed to me, that they handled everything so quickly and so matter-of-factly that this wasn't anything too big to worry about.
Thursday, I learned that they were a bit more worried than what I was initially led to believe. And so with this episode in the not so distant past, Dr. Yang does not want to risk any such episode again any time soon. He told me that most transplant surgeons do not mess with the time proven cocktail of the three immunosuppressants that I'm currently on until, at the very least, the 3 month mark and prefer waiting until 6 months out.
Not completely dismissing my problem with the tremors this time, he scheduled me to see him on Halloween (very close to the 3 month mark.) He will then review my blood labs from the past 3 months and will council me as to whether or not we can safely make a switch.

And so it goes.

Thanks for checking in here.

Friday, October 4, 2013

You have to learn to live with what you can't rise above....

Yesterday at clinic I arrived at 7:15am and had the obligatory bloodwork done and true to their word when I walked into clinic at 8:30 they already had most of the results.
Incredible.
I was then greeted by Dr. Yang, not Dr. Narins as I had expected.

- A little aside here.

Dr. Yang is the "Big Chief" at Pinnacle transplant center, he is a brilliant man, a renown transplant surgeon who has been at it for a very long time, and everyone highly respects his expertise and skill.
However, where Dr. Narins (one of the surgeons who actually operated on me) will come in and sit down, talk to me, discuss things in detail, answer all my questions to my satisfaction, examine me, and explain the next course of action, Dr. Yang comes in with a wonderful smile, shakes my hand, tells me how great I look, explains that my "numbers" are perfect, (textbook perfect yesterday.) and gives me short answers to my questions and leaves.
He is very amiable, but he is very busy man and I get that feeling.

Dr. Narins had told me he would change me off one of my meds to something different yesterday to ease the tremors. Dr. Yang, not so much. Instead he boosted one of my drugs that I'm already on in an attempt to calm things down but does not want to make the big drug change until.......and get this.......
AFTER NEW YEARS.

Can you say GRRRRRRRRR?

I about swallowed my tongue!!! I said WHAT?!?!?!?!? I mean these tremors are really bringing me down. They are relentless - 24/7.
The only pretzel-logic answer I got was: "You don't want to be in the hospital over the holidays!"
"True words" I said, "But Thanksgiving is still two months away!" to which he repeated:
"You do NOT want to be in the hospital over the holidays!
Just tolerate the tremors through the holidays then we will make the big switch afterwards."
Maybe it's just me but......this seemingly significant possibility of "being in the hospital" because of a med change doesn't sound like a very good way to start the new year.

Bob is a bit bummed. I mean, everyday, people ask me how I am feeling and I want to say "Great!"
instead I have to say "As soon as they get the meds worked out I will be great."

On other fronts, they took me off of CellCept (after I just received 60 days worth from the pharmacy) and put me on Myfortic which is a slight derivation of CellCept, hopefully w/o the side effects associated with CellCept.

I know, I know,....you warned me about this Jan.

As for the nagging cough, they agree with Dr. Daly's treatment and want me to follow his instructions.

So what started with the joy of "Your numbers are text-book perfect" was tempered a bit with everything else.

But this is my road and I'll walk it.

Sorry for all the bitchin' today. I'll cheer up for next time.

Thanks for checking here.

Wednesday, October 2, 2013

Dos Meses

Two Months
 
Well it's kinda hard for me to believe that it's been two months since my transplant surgery, I mean it's been a twisty, curvy, sometimes rocky road and two months ago, at this very moment, I was under....waaaaay under and under the knife. I remember being wheeled to pre-op and thinking "I can't believe that this is actually going down" and resigning myself, as the song goes, "to gravity and the unknown."  In retrospect, I should have been a lot more scared but the Pinnacle people know just the right mix of drugs to give you so the anxiety level is maintainable. Looking back at some of the posts from that day now almost seems like history.
 
And so.....as I mentioned at the one month benchmark (and probably will again for months to come)
I have been looking at the clock and thinking about where things were at this time on August 2nd.
 
 
Again, thanks to all of you for your support, and prayers through it all.
Please keep 'em coming.
 
 
As for news.... tomorrow I was scheduled to have clinic in Harrisburg at 8:30 but they called this morning and want me to come up at 7:15am to the hospital to have some extra blood labs done as they are finally trying to address some of my most severe side effects namely the ttttttttremors, nagging cough, and fitful sleep. They called yesterday morning to tell me to get a chest xray and then had me go see my primary care physician Dr. Daly. This cough has been increasingly troublesome for the past three weeks and it is really hurting my longest incision over my pancreas to the point where I darn near double over when I cough. 
So I hope we get some closure on that AND the tremors.
 
My bloodwork from Monday showed my platelets are running high so I'm sure they'll adjust something to work on that too. All my other important numbers - creatinine, white cells, lipase, glucose are all super. So despite side effects the docs are going to say - 
"The organs are working wonderfully!"
And really......that is the goal.
What a lucky guy I am.
 
I'll let you know what I find out tomorrow.
 
Thanks for checking.