Six months later...

It has been six months since my transplant. Overall, I think I am doing great. In my appointment with my transplant nephrologist last week, he said that my lab numbers look great. If these numbers continue, I may just need to go to the labs once a month. My doctor even said that these are ideal for a kidney transplant recipient. My last creatinine was 0.95! My husband and I couldn’t be any happier.

I am elated with these results and am very determined to maintain these numbers. For me to able to maintain these great numbers, I need to remember to do these key items.

Take your medications regularly. Taking your immunosuppresants, anti-infection, and other maintenance medications are very important for any transplant recipient. This ensures that the immunosuppressant levels, which are critical in preventing the body to reject the new kidney, are at optimum levels. I should read my post on taking your meds as a reminder.

Keep moving.  This means exercise, exercise, and more exercise. I find that when I walk, my body (and mind) is able to function more efficiently. I make it a point to exercise at least 20-30 minutes a day whether if it is walking, practicing aikido, or dancing hula. Sometimes I do overdo it, like last Saturday, when I went to a 2-hour hula workshop and walked almost 40 minutes (one way) to go to a baseball game. While it is important to move, do it in moderation and consult your doctor before you start a new exercise routine. I have to keep reminding myself that my surgery was not too long ago. Rest and recovery are still equally important.

Maintain a balanced diet. Must. Eat. Healthy. Since I now have a healthy kidney, I can pretty much eat whatever I want. I do not have any more restrictions on phosphorus (and therefore no need for binders) so I can add whole wheat and other grains in my diet. I loved experimenting on different grains. When I was in dialysis, I was pretty much limited to white rice and white bread. Now, I can have quinoa, barley, corn meal, and oats (my favorite). I still need to be careful though; immunosuppressants may increase potassium in one's system so you may need to watch high-potassium foods like bananas, mangoes. and coconut. More on this later…. I feel a post coming.

Maintain food safety. Just as important as keeping a healthy diet is maintaining excellent food safety.  Bad bacteria in foods can make you sick, and since my immune system is lowered, I am more susceptible to illness. Also, my nutritionist said that certain salmonella can considerably damage my kidney. Maintaining good food preparation habits and selecting reputable restaurants with a clean kitchen are very important. Check the National Kidney Foundation's article on Food Safety or my previous post on this.

Keep hydrated. My new kidney needs to be constantly hydrated, so I need to drink plenty of water. In fact, my excellent creatinine results were partly due to the summer heat. I was drinking so much water since I was always thirsty with this summer heat. To my surprise, my creatinine considerably improved. I do need to go to the bathroom more… deal with it!

Manage your stress levels. Stress has been known to adversely affect one's health: whether it is stress from your medical condition, work, or relationships. I try to keep my stress-levels low by having a positive attitude and surrounding myself with positive people. I also try to have some quiet time either through meditation, walking, or even blogging. These allow me to center myself and hear my thoughts better.

Have a good support system. Having an understanding husband and good close friendships were very key during my recovery. My husband provided most, if not all, of the physical help needed in that period: cooking meals, cleaning, driving me to doctor’s appointments. He was a rock, and I am very grateful he is here to support me. My friends also provided encouragement and support even though some of them are hundreds, if not, thousands of miles away. They kept my spirits up and kept me going. I need to remind myself to maintain my relationships and never take them for granted.

I still have a long way to go, and getting through these last six months is just a step in the process. I want to have a healthy kidney for a long time, maybe for the rest of my life. To accomplish that I need to continue to always keep these tips in mind.

I’d love to hear from you if you have any more advice for me. Wish me luck!!!

Walk On

“To grow, to discover, we need involvement which is something I experience everyday, sometimes good, sometimes frustrating.”

- Bruce Lee

Feeling down this week.  There is a situation in my hula group with one of the newer students, and I think her behavior will force me to quit the group. I am deeply saddened and extremely angry with this. I love dancing hula, and I have been in this group for more than five years. To leave because someone is uncivil and disrespectful is disappointing.

This situation has caused a lot of stress and agony.  My blood pressure has been elevated and have not been sleeping very well. I have been very sad, angry, and moody as a result of this.This week, only after two days of crying, anger, meditation, and introspection, I have finally returned to my happy normal self.

In my introspection, moving on may be the best move for me. If one is in a negative situation, the best defense is almost always to walk away.  Some may think that it is running away, but I interpret this as taking the high road, avoiding a truly destructive situation, and not stooping down to their level. As someone who is only had a kidney transplant less than six months ago, having a positive attitude is important.  I feel that given my priorities, it is not worth it to attempt to continue going to a place where I regularly experience stress, especially if it is an extra-curricular activity. As much as I love my teacher and most of my hula sisters, I have a new kidney to protect, and weekly stress and frustration will not be beneficial to it and my overall health. 

I still have other activities to enjoy, and will continue dancing hula, whether it is on my own or with a new group. As Bruce Lee had said, “Walk on”.

Take your meds!

I recently saw a (web) presentation on medication adherence. According the presenter, about 50% of patients living in developed countries do not follow treatment recommendations. I was very surprised to hear this statistic (So surprised, that I even confirmed it via wikipedia). Fifty percent is a huge number, and I think that taking your meds the way your doctor has prescribed them is critical to improving your health, especially during one’s recovery from surgery.

Bracelet to remind me of my binders

As an example, when I was getting dialysis treatments, the dietician and the charge nurse always reminded me to take my binders to keep my phosphorus levels low. I hated those pills – they were horse pills (See my previous post – Got pills?). I could not count how many times I almost choked on those things. Regardless, I took them with every meal and snack. I was determined to keep my phosphorus low, even if there were times when my phosphorus levels were going the opposite way and I did not think the binders were working.

After my transplant, taking my medication is even more important, specifically the anti-rejection or immunosuppressants. To ensure that I have adequate levels in my blood stream, I need to take my medication every 12 hours, like clockwork. It is very important. I have an alarm in the morning and in the evening as a reminder and a prescription diary to keep track of what I take daily.  The transplant pharmacist once told me that a transplant recipient lost the kidney because that patient kept forgetting to take his/her medication on time. Since I am determined to keep this kidney for a long time, it is very important to me to take my meds at the specified time. 

I have an alarm for meds!

Don’t get me wrong. I do forget my medication sometimes. I can think of more than a handful of times when I forgot to take my blood pressure pills or even my phosphate binders. The key is to make it the exception, not the rule. For blood pressure pills, take them as soon as you remember. Also, make a note on what occasions make you forget to take them (mine is usually when I am in a hurry or distracted) and try to correct it.

In that presentation, I learned that many people never order their prescriptions. Some order them, but never pick up their filled prescriptions from the pharmacy. Other people pick up their medication, but don’t follow their physician’s instructions.  Although I have had a history of researching every medication that has been prescribed to me and sometimes questioning why I take them, I usually work with my physician to get a win-win situation. As an example, I have not been a big fan of taking statins for cholesterol. I’ve read of the side effects, have seen those side effects first-hand, and would prefer an alternative drug. However, I worked with my then primary care physician to lower my cholesterol (specifically triglycerides) without taking statins. We found an alternate drug. Ironically, I am taking statins now for maintenance (I may have a conversation with my transplant nephrologist after a few months).

That presentation inspired me to be more mindful of taking my medication regularly, and I am hoping this post will inspire you to do the same. Do whatever it takes to take them on time and at the correct dosage, whether you need to set an alarm or keep a diary. “Not taking your medicine as directed can also lead to other health problems, especially if you already have asthma, diabetes, or high blood pressure” (From ScriptYourFuture.com). And remember, diabetes and hypertension can lead to kidney disease.