Relief: Update from my Last Follow-up Visit

My husband and I had an excellent visit with my nephrologist at the Transplant Clinic this week. The doctor gave me a check-up, and then we spent the remaining time of my visit addressing my concerns. He probably spent twice as much time with me than normal, and I am very grateful for it.

Here are the highlights:

·       The high blood pressure may be due to Renal Artery Stenosis or the narrowing of the renal artery. In this case, it may be due to the way my grafted artery, now grafted to a new kidney, is healing (To simplify: it could be the result of the actual transplant procedure).  The doctor assured me that it is not something that I did or caused by any cholesterol build-up. We will be having an ultrasound next week to determine if it is indeed stenosis.

·       The variations in my creatinine are normal. Creatinine is a waste product in the blood, and creatinine level is one of the measures of kidney health. For someone like me, even though it increased by 0.15 points, it should be okay. The doctor also said that I should ignore the standard range of less than 1.11, because this applies to people who did not get a kidney transplant. For me, I should not be concerned as long as my creatinine is less than 1.50.

·       Unfortunately, the cause of weight gain is unknown. My doctor said that since my weight has been fluctuating over the last two years, the weight gain is probably normal. They said I should be concerned if I gain more than 10 pounds. In retrospect, when I was on dialysis, my weight fluctuated from 66.8 to 70 kilograms (about 147-154 pounds), more if we really had a great weekend in Monterey or the California Wine Country. I would think that this is my normal range. Hopefully, once my health stabilizes, my weight would settle in as well. I will still keep an eye on it.

Please keep in mind that these conditions only apply to me. Each patient is different and has circumstances unique to that person. For anyone else, I hope this will serve only as a clue to what you are experiencing, but consult your doctor for the actual diagnosis. I guess that is what makes Medicine so interesting and challenging: it’s not like engineering where everything is exact and precise. It really is more like an art.

I mentioned to him that I would not have been as concerned if their documentation (see image for reference) did not state the signs of kidney rejection include fast weight gain (more than four pounds in a week) and an increase in creatinine. Increasing blood pressure is not a good sign either, because that can impact kidney function (My husband later explained that the documentation is generic and meant to reflect a broad patient audience). The doctor said that they might need to change, update their documentation. Lastly, my anxiety would probably have been reduced if we had more frequent visits; the doctor remedied that by scheduling our next visit in two weeks.

Here’s to better days ahead!