Life On The "T" List...: July 18, 2011

After going through what I went through six weeks ago, as many of you have before me, even a simple follow-up trip to the doctor can be a little nerve-wracking.

Why? Because if you are like me, and I am assuming many have had similar experiences over the course of your lives, you have spent a great deal of time in and out of doctors offices from anything from a simple cold/flu to something like preparing for surgery. A trip to the doctor for us is far from simple any more. Even the most positive minded of us get a little bit of apprehension when we have to hear the results of lab work or an x-ray or CT Scan, or what have you.

So, although I have been feeling fine…check that…feeling Great since the transplant, there is always that little bit of doubt that creeps into my consciousness…and this appointment was no different. I guess what was fueling my apprehension was the fact that I can see the results of my labs online several hours after they are drawn. I would go so far as to say that I am a bit obsessed when it comes to wanting to know my labs, especially my creatinine (which incidentally has remained around 1.0, and my last result from this past Friday was 0.9 – these are very good numbers).

I will admit that I don’t know what all of the lab values mean or translate to, which can be very dangerous to ones psyche. Some of the other numbers that I follow closely are potassium and sodium levels, as well as my hemoglobin and hematocrit levels. All of these levels effect both the heart and kidney function. However, a low hemoglobin level usually is an indication of anemia. With hematocrit, it is specifically a measure of how much of the blood is made of red cells. The hematocrit is a very convenient way to determine whether the red blood cell count is too high, too low, or normal. The hematocrit is a measure of the proportion of blood that is composed of the red blood cells. (WebMD).

Both of these numbers dropped like a rock just after the transplant, which, apparently is not uncommon. This could have also explained why I was feeling some angina several days after the surgery. And looking at my lab values over the course of the last six weeks, both of these levels have been gradually rising. But what I wasn’t seeing go up was the levels of my White Blood Cell count and my Red Blood Cell count.

When I met with Dr. Pavlakis on Friday, I asked her if she was concerned with any of my blood levels. I tried to be as nonchalant about it as I could, without letting on that I was concerned about it. Fat chance…she could see that it was worrying me a little. But with a wide smile, she said that she was actually happy with where my numbers are, especially only being six weeks out from surgery. She went on to explain that two of the medications I am on are actually suppressing my white blood cells – the Cellcept and the Bactrim – she said that the white blood cell level may never return to “normal” because of the work the Cellcept and the Bactrim are doing.. As for the red blood cells, she said my new kidney is working fine but it takes a while for the production of Erythropoietin to really kick in. Erythropoietin is a hormone produced by the kidney that promotes the formation of red blood cells by the bone marrow. When this not happening properly, kidney patients know this very well, the erythropoietin is replaced by an injectable, man-made drug called Procrit (generic = epoetin alfa).

All in all, I guess this was a case of worrying about something that I didn’t have to really worry about…if Dr. Pavlakis is happy, then I am happy as well. As far as the remainder of the appointment went, it went like clockwork – I have hit all of the benchmarks that they have put out for me so far, which means I was just cleared for exercise (although nothing to do with my abdomen for another month or so)…off to the treadmill! And by the way, a very happy birthday to my cousin Karen, who turns _?_ tomorrow (I don't think she wants me telling her age any longer!).