Filed under: @ 12:30 pm

Just got back from our second recheck visit this week. Things are in the “keep on keeping on” stage at this point. Andrew’s primary incision site is leaking less than it was which is good and the lab values from Monday were excellent. BUN and creatinine were only just above the normal range for the first time in who knows how long, and the rest of the blood chemistries were well within tolerances. Andrew’s blood cell counts are still normal as well which is fine, but kind of amazing considering how much immunosuppressant he’s taking.
Physically he’s still weak and easily fatigued (quelle suprise) and he’s been having these weird body aches. No fever, but fever-like generalized aching. Dr. Transplant Nephrologist (whose name is something multi-syllabic that starts with a “V” that I will remember eventually) says that the aching is either the fact that Andrew has been incredibly sparing with his pain meds or an early indicator of serum sickness.
Serum sickness is an immune reaction to a protein based immunomodulating drug. Like snake antivenin or the rabbit protein based immunosuppressant medication that Andrew was administered peri-operatively. No big huhu if serum sickness is the culprit, it just means a course of steroid, but the aching is taking it out of him. So in an inexplicable bout of cooperation Andrew has agreed to be more regular and more religious with his narcotic pain meds over the next few days to see what sort of difference that makes.
This means that after having some truly excellent egg rolls for lunch (shout out to Kau Kau which, if you’re a Seattleite, you should definitely investigate) Andrew is currently snoozing which is fine.

Especially since the next wave of contractor chaos has begun and there are men from System Pavers banging around and digging shit up in the back yard.
Me? I’ve had my egg rolls and I’m thinking it’s probably about time to go putter in the FRONT garden.


Filed under: @ 12:02 pm

In late 2007 or early 2008 Andrew’s internal medicine specialist started noting some changes in his kidney values.

–Sorry, for those not medically inclined, by “kidney values” I mean “parameters in the blood that we use to monitor renal function”. Like “normal” or “normal range” (which means “the bell curve of individual metabolites measured in the blood that are considered normal in an adult”) “kidney values” is medical shorthand.–

Anyway, change in kidney values, right.
Because he is diabetic Andrew’s internist wanted to know why there were changes in Andrew’s kidney values. Those sorts of changes aren’t unusual to see in a diabetic patient, but Andrew was a little young for them to start showing up. So the internist, of course, was curious. Which meant biopsy.

–Another side note: Yes. I am a medical professional. I am, however, a medical professional for things that don’t tend to walk on two legs and stuff involving people and medical care tends to give me the squicks. The idea of having someone jam a needle into my kidney makes me weak in the knees. —

Renal biopsy.
Scheduled and done in June 2008.
Turns out that Andrew’s nephropathy isn’t really diabetic nephropathy it is a heritable immune mediated nephropathy that is complicated by diabetes. When we told Joan of the diagnosis she mentioned that her father had had some sort of chronic kidney issue, but kidney disease hadn’t been a contributor to his death.
The information is vague, but if I were to take a medical guess at it I’d suspect that whatever was going on with Grampy’s kidneys was probably similar to whatever has been going on with Andrew’s kidneys. It’s just that Andrew is concurrently diabetic which accelerated the renal disease process.

I don’t know why it’s so important to me to emphasize to everyone in sight that Andrew’s kidney disease didn’t start as diabetic nephropathy, but it is so there you go.

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