Saturday, December 22, 2007

No one is excuse... this could also happen to you

Just want to share the recent experience in the hospital that I never thought would happen to me.

My admission at Emergency Room was triggered by the increase in my serum creatinine of 1.2 to 1.6 and a repeat crea a week later of 2.3. My regular physician was on leave at that time, so someone relieved for his post. Initially, he calls it as a sign of rejection but not quite sure what's the cause, no complications and other symptoms physically present except for creatinine results. So he admitted me first at Emergency Room and call up another doctor who will attend to me. Tests have been done, except for renal graft biopsy of my new kidney, because there's no available biopsy room yet. After seeing the results okay (except creatinine that decreased a bit from 2.3 to 2.0) the doctor said, must be on toxicity of medicines. So I was discharged the following day and just instructed me to have a repeat serum creatinine test, make a follow-up after 2 days and reduced the dosage of one of my medicines.

I went back after 2 days for check up with my regular nephro, but still creatinine level is at 2.1. He reviewed previous instruction and scheduled me for the biopsy and arranged a room for me. The following day the biopsy was done and results was available in the afternoon. Another nephro who is monitoring my condition (I think a fellow of my regular nephro) discussed the results with us. It was actually a bad news because according to him that the kidney that I've got from my donor is defective, so it's a chronic rejection already. In months time I'll have to go on dialysis again and probably have new kidney transplantation. Mom and I just looking at each other and while the doctor kept on explaining, I am just quiet and was tongue tied at that moment. I keep myself compose and at the back of my mind questions arises. Like, how did it happen when the donor undergo rigid tests and work up? If chronic already, why did they accept it? I told to myself that I will never undergo dialysis again, I can fight it 7-10 years more (full of spirit) and if it is faith then let it be. What I worry much is my brother, who lost his kidney for me because his just starting to have his own family. When the doctor left out, mom and I discussed what should be done in the future, no plans for dialysis and another implant. I also texted and called my regular nephrologists, explaining the result and requested him to visit me after or before his clinic. He responded and paid visit and ask me what's your problem, smile and said its nothing, the diagnosis is just a slight rejection which can be done to pulsing to normalize the creatinine level. He gives his assurance and explain that he already communicated with the doctor and the laboratory department. In short, there was a mistake that arises from the laboratory, the results that was forwarded and read was not my biopsy. My mom who almost felt like dying due to stress and depression has regained herself and felt relieved. We'll get back with the other doctor mom said.

The following day, the doctor who read the wrong results immediately admitted thier fault and very apologetic with what happen, mom explains its okay we understand, however this will not be the case always, as to some families and patients you'll get different reaction. Hopefully this will be a lesson and we should be very careful next time and coordinated properly. Because it's important that we are considerate on the feelings of the patient and families as they are also undergoing depression and anxiety ( very well said mom).

I know that there a lot of worse cases that has been featured in news and depicted in some TV soap operas and movies compared to my experience. Who would think that I will personally experience such thing in the hospital? Medical practitioners are human too, but what if it takes life.. How will you react? Luckily mine was just an accidental switching of laboratory results and was coordinated at once with my regular nephrologists.

No one is excuse... this could also happen to you.

Thursday, December 20, 2007

MY FIRST TRIP after 3 months operation

My first local trip after my 3 months post kidney transplant was last November 30, 2007. This was a previously arranged schedule with my family and with my physician consent. This place is dubbed as the Pilgrimage of the Northern Capital of the Philipines, a religious shrine with countless miracles, tales and healing powers. Our Lady of Shrine of Manaoag, located at Pangasinan

I have been here in many occasions like my birthdays, after my graduation, board exam etc......Today I'm here together with some members of the family for a thanksgiving mass. We attended mass at 10am in the morning. After the mass, we buy candles and offer prayers. I went to the cashier office for a special mass intention for myself and friend (a brother to me) who is also undergoing health ordeals. The mass will be celebrated the following day, Saturday coinciding with his complete physical and laboratory check up.

By 11:30am we already left the shrine and take our lunch. Our second destination is an overdue promise for my niece and nephews, a trip to City of Pines "The Summer Capital of the Philippines", Baguio . I called up my friend to arrange the place where we will stay. And since my "pamangkins" are first timers including mom and my sister in law (hehehe) I really felt their excitement on their faces. I just watched them and smile and try to relax for I have been here for so many times. We reached Baguio at around 2pm, and my friend came to fetch us and accomodate us in the condotel to rest and arangge our things for 20 minutes.

First place we visited is the Mines View Park: Instead of overlooking and site seeing (mom and sister in law) they enjoy shopping and looking for different kinds of souvenir items , pasalubongs and a like ....girl thing hehehe. My friend and I just keep on the following the kids and the oldies (hahaha!) as if were body guards.

Next stop: Wright Park horse back riding. In here my pamangkins together with their mom really enjoy it. I'm happy seeing them how I wish my older brother (their dad) is with them. My friend and I would like to try also riding but I cant bear the smell, and afraid it my affect my health condition, in my next visit probably.

Horse back riding activity finished almost 6pm and its really cold already but before we return to the condotel we dropped by at SM to have short window shopping. My friend and I separated and went to grocery to buy some foods. Line to the cashier grocery is very long, so I ask him to fall in line while i'm doing the shopping to save time hehehe! Then we buy also foods at Chowking for our dinner.

Its already a great day and time to rest, so will have more energy for the next day activity. My mom slept already, my friend and have some talks and watch the tv. Paul told my pamangkins that there's a lot tianggian at night near Burnham Park, and since our condotel is infront of the place, they went to an extended shopping to buy stuffs for their classmates, silvers , purses etc... They are really enjoying, very enthusiastic and energetic.... seems they dont feel the cold breeze outside.

Second Day: Burnham Park more of picture taking and boating experience.

(My nephew and niece)

(Mom and youngest nephew)

(Chit2 and my friend Paul)

(Paul - aka boatman)

(With my mom and pamankins)

(With mom, pamangkins and their mom)

(Mang Boy, Paul, my mom and pamankins)

Next stop Strawberry Farm at La trinidad Benquet, traffic is quite heavy and when we get there around 1030am, there's no much available strawberry for picking. I remember when I experienced picking strawbery, it was really exciting and fun. My niece got few shots instead to show her classmates. I would want them to experience what I had, anyway there will always be a next time.

We leave the place almost 11am, we let the kids and Mang Boy to go ahead at the hotel, while we headed to market to get some fresh veggies and buy foods for our lunch. We leave the condotel at 2pm and headed back to Manila.

It was indeed a tiring trip but I great experience for my family. My mind and heart seems so relax and at peace. Two things that I accomplished in this travel, Have shared thoughts and special prayer for a friend for his immediate recovery. Being with my pamankins and fullfilling my promise for them. The bonding experience with the family, seeing their faces full of joy with an extraordinary feeling and happiness.

Monday, November 26, 2007

Seven Years Struggle

In 2000, during my annual physical examination, I noticed that my urinalysis results has blood occult and +++3 albumins . Though findings has no remarks, I consulted our company doctor and he refers me to a urologist. Urologist has no findings based on some additional laboratory test . I seek the services of a nephrologist and check me for all possible signs but to no avail. The nephrologists requested me to undego Renal Biopsy, a laboratory procedure to obtain a sample of kidney tissue. Wherein Ultrasound is used to mark the biopsy site. A biopsy needle will be inserted into the skin to get a sample for analysis. Results showed clinically, asymptomatic urine abnormality and glomerulonephritis (GN) a general term for kidney inflammation. My nephrologists explain that my case is different from others who have kidney disease but will try if medications can improved it. So I take the medications prescribed , but when I had my medications especially the immuno suppressant - steroid tablet ( which will decrease body immunity system), I was hospitalized (3 consecutive years) for having pneumonia.

In 2003, I seek another doctor to handle my kidney disease. Medicines were changed and I have better body condition, though my doctor emphasize that my medications is only to control the level of creatinine in my body. Creatinine is a chemical waste that is generated from muscle metabolism. It is carried by the blood to the kidneys, which filter it from the body. In 5 years I managed to continue my work without being hospitalized, can travel and do the usual things I do, though my creatine is increasing and some of the symptoms of kidney diseases were noted already like:

  • Abnormal blood results: low hemoglobin, high phosporous(P), high creatinine, high potassium (K) and low calcium (Ca)
  • High blood pressure
  • leg cramps
  • Easily get tired (Fatigue/Weakness)
  • Back Pain

In early 2006, doctor advice me to go on dialysis, but I refuse because I think and feel that i'ts not yet time. However, my creatinine is already 14 (normal range is 0.5 - 1.3) and my kidneys is nearing on end stage chronic GN, this a condition that exists when the kidney fail to stop or cease nomal funnction causing build up toxic substances within the body. Usually detected through blood test, serum creatinine. In physiology, it is described as decrease in the glomerular filtration rate to function adequately (GFR). The GFR is the differential contribution of left and right kidney. End 2006, I decided to have a fistula on my left arm in preparation for my dialysis. The surgeon created an access (Fistula) connecting one of my arteries directly to a vein. The arterial blood has higher blood pressure than veins and causes swelling of veins involved in the fistula so it can be used for repeated needle insertion. These takes several weeks to be ready for use.

In May 2007, I started my Dialysis; It is the process of removing waste toxins from the blood (filtering) either by passing it through a machine (hemodialysis) or a lining of the abdomen (peritoneal). In my case, I choose the hemodialysis. A machine called dialyzer will clean your blood of harmful waste and toxins (extra salt). This will helps control blood pressure and keep the balance of important chemicals in the body. The blood travels through tubes into dialyzer (first tube) which filters out waste and extra water. The newly cleansed blood then flows through another set of tubes (2nd tube) back into your body. This is done twice a week at four hours per session.

After my dialysis I still report for work to train one of our QA staff to handle my load in my absence. At that time we have decided (my family) to undergo Kidney Transplantation. It is the process of implantation of a kidney from physically healthy individual through surgical procedure from a comparable donor recipient. My brother (kidney donor) and me, had a series of laboratory workout and after completing the tests and securing clearances from different doctors, we were advised to wait for the schedule. Last September 4, we were admitted at National Kidney Institute and the operation was done the following day. This is how my kidney looks now, the old kidneys were not remove but the new one is that lower right.

My donor leave the hospital after 4 days, I went home September 15 and the following day is my birthday. Truly this is the greatest gift I ever had, a blessing for having a kind and loving brother and a supportive family. I thank god for making my brother an instrument to prolong my life and continously blessing our family. For making my faith stronger and giving me courage in facing this struggle. Being a post a kidney transplant takes a greater responsibilty, because the success to have a longer life depends on every transplant indvidual, a change of life style should be considered and need to be followed. After all, having a new kidney is a second life .... a new life....