I am happy
to report that after my renal angioplasty last Friday, things seem to be back
on track. At the risk of sharing too much information (or TMI), I am so happy
to be peeing again. The last two weeks I had extreme fluid retention and was
barely urinating. It’s very scary for someone who just had a kidney transplant,
because a lack of urinating and fluid retention is often a red flag of transplant
rejection. To add to that, fast and unusual weight gain can be traumatic to
anyone, particularly a woman – real weight or not.
I am
writing this post not only to report success, but also to take a look back at the
entire process. I am not complaining, but hoping that something can be
corrected. I have been extremely frustrated, mostly rightfully so, and have
been angry at times.
Here’s some
background for those not familiar to my previous posts: I reported an increase
in blood pressure almost a month ago. The
nephrologist and transplant coordinator said that it was normal. I also told
them that I was gaining about a pound a day, and that I suspected that the gain
was mostly retention of fluid. In spite of my saying that the weight gain seemed
unusual, they said that it too was normal.
After almost
ten pounds of extra weight and some 50 points higher on my blood pressure’s
systolic number, along with two weeks of anxiety, an ultrasound was ordered. The
prognosis: there is a possibility of a narrowing of the renal artery (or
stenosis). It can only be confirmed through an angiogram and, if necessary,
repaired (probably) by angioplasty and, perhaps stenting. That brings us to now…
My
frustration is that if this situation was caught earlier, it may have prevented
my blood pressure becoming extremely elevated and my weight out of control. I do not understand why it is that when a
patient reports weight gain and increasing blood pressure, why can’t our health
care partners automatically recommend a simple ultrasound to rule in or out
Renal Stenosis. In one of my readings, I found an article that mentioned that transplant
renal artery stenosis typically
presents itself 3–24 months after surgery, although it can present at any stage
after transplant (Note: access to the article may require set-up of a free account). Also,
up to 12% of
transplant recipients with hypertension (like myself) may have functionally
significant Transplant Renal Arterial Stenosis. Last but not least, if this was caught earlier, I would
have been able to handle it during my medical leave, rather than my having to
take time away from my work; it really does not look very good in your first week
back at work.
I felt that
I was somewhat stereotyped. Just because a woman complains about weight gain
does not necessarily indicate that she needs to go on a diet or engage in more
exercise.
As it
stands, it seems that “appropriate care” is up to the patient; the patient must
be persistent with the physicians and nurses so that action happens. I do
believe that we need to partner with our health care providers to ensure the
best of care, and that is what we tried to do. It should be, however, a
“two-way street” with much more communication from our health care partners
taking place. As an example, I am not sure if there actually was a medical
reason behind the angiogram delay. If so, that should be explained to the
patient. Fortunately, I’ve found that my nephrologist has been explaining
things more to me recently, and has even shared with me pictures from my
angiogram. I am very pleased with this change and hope that it continues. Perhaps
doing one’s homework and persistence really do pay off.
As a final note:
I am happy to report that I have already lost about seven pounds since the
angioplasty surgery. I also received some meaningful parameters from my doctor
as to when to seek advice about something perceived serious. I do still hope that
I will lose all the remaining weight that I gained, without dieting. I know that this may not be realistic, but one can always hope.
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