Transplant Clinic
I often have flashbacks to my time on dialysis and I constantly think about how close I came to dying; So, I feel a tremendous amount of pressure to keep this kidney as long as possible. For various reasons, I feel a little extra pressure from my donor this time around. So I've been extra health conscious, I've been eating more fruits and vegetables, I'm exercising about as much as I did 12 months after my first kidney tx. I've been avoiding sodium in my diet (which the doctors are now saying is unnecessary given how low my BP is), taking my medication as prescribed, etc. I don't drink. I don't smoke.
I am eternally grateful to Dr. Jonsson and the staff at Inova Fairfax Hospital for performing my transplant operations; however, I really hate going there for Clinic. It's OK when Dr. Jonsson is on duty, but the other doctors in the past have caused me some concern.
For the past couple of months, I've been experiencing blood pressures that are LOW for me. Yesterday at the Transplant Clinic, it was 107/61. The doctor at the clinic warned me that low blood pressure can damage the transplant and he prescribed Florinef to raise my blood pressure. RED ALERT DAMAGE? I called my nephrologists and they calmed me down. Apparently, there are people walking around with normal BPs much lower than mine. There's no evidence that my blood pressure is damaging the kidney. So, I'll be going in for blood work, an echo cardiogram, and doppler ultrasounds of the fistula.
I had asked the doctor at the clinic if my fistula could be responsible for lowering my BP, and he said it would have the opposite effect. That didn't make sense to me. Whether it's a hydraulic system, electrical system, or a pneumatic system, if you poke a hole in it before the load (in this case the capillaries) and short circuit it back to the start, you're going to lower the pressure in the rest of the system. The question is whether that fistula is large enough to influence the pressure in the rest of my body. If the fistula is the problem they can always tie it off.
Three months ago, the same clinic doctor asked me what we were doing to mitigate the effects of the MPGN on the transplant. I told him I was unaware that anything could be done, and he listed a few things that I had discussed previously with my nephrologists. To be clear, there is currently no scientifically backed cure for MPGN. The Doc mentioned Plasmapheresis. Once, some one tried it and that seemed to clear up the problem. It could have been coincidence and we don't know how many people tried Plasmapheresis and didn't get their MPGN cured, and it is not without risks. My understanding is that it is like dialysis in that blood is removed, treated/cleaned, and then returned to the body.
In the reign of Queen Kidney I, I remember going to the clinic and hearing something that scared me so much, I had to schedule an appointment with my nephrologists right away, even though I was scheduled to see them three months down the line.