The Biopsy Test Results are Back

We had Pete’s doctor appointment last Thursday, and I took a half day so that I could go. I’m pretty sure that everyone knows about the Best Doctor’s report (a benefit through work, they send his medical history to a leading nephrologist who writes what he thinks Pete should do). Out of that came a diagnosis of IgM-associated mesangial proliferative glomerulonephritis and a recommendation for Peter to try a cyclophosphamide.

According to Pete’s doctor (Ahmed), there was more scarring in his kidneys that he would have liked, but the biopsy did show that the Prograf Pete’s been taking (an autoimmune suppressant) has become toxic to his body. At his last appointment, he decreased Pete’s dose, and from that Pete’s kidneys have gotten better. Now Pete will be 100% Prograf free and taking Vitamin D supplements, because his parathyroid hormones are a little high (secondary hyperparathyroidism). Secondary hyperparathyroidism is common in kidney patients, and just means that his calcium levels are too low, so his parathyroid hormones are taking calcium from his bones to  go into his kidneys and intestines. A lot of times kidney patients end up with bone problems, and that’s why. I just think that it’s weird that you can have hypothyroidism AND hyperparathyroidism, but Ahmed explained that the two areas are right next to each other in the thyroid and do different things. You can see I’m learning a lot from all this! 😉

Ahmed said he’s already doing 90% of what Best Doctor’s recommended, and it just confirmed what he had already diagnosed with Pete. He doesn’t recommend that we go with the cyclophosphamide just yet, and wants to see how things go with the Vitamin D, Aranesp (shot for anemia, also common in kidney patients), and no Prograf. Pete will still stay on all of his other stuff, but Ahmed is hoping that the toxicity from the Prograf is what was causing Pete’s fluctuating protein/creatinine levels. We’ll reevaluate in 9 months. We were considering switching to a Mayo doctor that Best Doctor’s recommended, but I met Ahmed and like him a lot. And he said that me, him and Pete were a team, so he’s sold me on staying with him for now!

A transplant will be the end result of all this, but all of the meds Pete takes are to lengthen the amount of time that that will happen in. Best Doctor’s said that if Pete’s protein/creatinine levels continued to go up the way they have been, a transplant would be likely in 2 years. Now that his number are falling again, Ahmed seems confident that the Prograf was the problem, which is great news, and that we’re shooting for 20-25 years. The longer we can put it off, the more technology that will become available—I just read that a lady had her kidney taken out from her belly button. Can you imagine???

Thanks for all of your love and support. I’ll be keeping you updated on everything, but no news is good news as far as I’m concerned! 🙂

Biopsy Time

In the morning, Pete will be having a kidney biopsy to check up on how things are going in there. It’s a fairly minor procedure. We have to be at the hospital at 6 am, the procedure starts at 8, he’s in recovery at 9, and we have to hang out there for a few hours so they can make sure that there’s no internal bleeding or anything like that. Even though I’m sure it will be fine, I’m more worried about how the anesthesiais going to affect him after. My dear husband thinks he’ll be attending a study session that night because he “felt fine after the last biopsy” ten years ago. I just don’t want him throwing up everywhere and feeling all nauseous and gross and in pain. I’m working from home afterwards (what kind of hospital doesn’t have wifi?!) tomorrow, and tentatively on Thursday depending on how he’s really feeling.

If your curious on what goes on in a kidney biopsy, here’s a link: http://ow.ly/1JUYj

To detract from that serious bit of news, here is a picture of a kitty who got a little confused about his footwear.

Best Doctors Really is the Best

After six patient weeks of waiting, we finally got Pete’s Best Doctor report back. It’s a little overwhelming for a few reasons. The doctor who wrote the report and answered all of our questions works at a Harvard teaching hospital. He backed up everything he said by citing 44 references. 44! And even though most of it was in English, the a lot of it was filled with medical terms that I need to look up still.

The doctor said that from 2003-2008, Pete’s kidneys were relatively stable, and his creatinine levels showed that he would have adequate kidney function for many years. Since 2008, his creatinine levels have jumped up rapidly, and if it continues this way, Pete might have to have a transplant as early as the end of 2012. But the doctor isn’t sure because Pete’s glomular filtration rate (GFR) has varied, so he thinks it’s possible that the medication he is on has become toxic to his body.

I’m hoping that the toxicity is the problem and a med change will do the trick. We’re not thrilled about the side effects of the alternate medications, but it’ll be ok. Best Doctors also sent us the name of a pretransplant kidney specialist in Jacksonville, so I’m looking forward to meeting him and hearing what he has to say. 2012 is a worst case scenario anyway, and with technology and the leads that we got from the Harvard doctor I think that we have a pretty good chance of avoiding that. If not, hopefully I’ll be a match!

The Adventures of Pete and His Kidneys (Or, Diffuse Mesangial Proliferative Glomerulonephritis)

Peter is obviously a major part of my life. With Pete come his kidneys. They have a life of their own, and enjoy making me crazy with every flare up of gout, every blood test, and every urine sample.

When Peter and I started dating, he would make trips to a hospital in St. Petersburg for checkups with his nephrologist. I didn't really know what it was about, because he never explained it past "my kidneys make too much protein." That was enough for me at the time. He didn't look sick, and never felt sick, and never really talked about it, so I wasn't too concerned. I thought that it was minor. If Peter slept over the night before a lab test, he would bring a big jug that would go in my bathtub for his 24 hour urine sample. It was a normal thing to me. It wasn't until we were engaged and I connected the gout he was getting to his kidneys that I realized that we were dealing with something big and unpredictable.

What Pete has is Diffuse Mesangial Proliferative Glomerulonephritis. It's a disorder that causes protein to be lost in his urine, which he told me, and also causes his kidneys to be inflamed. Other symptoms he has are high blood pressure, the occasional bout of gout, high potassium, anemia, and hypothyroidism. For all of these things he takes an immunosuppressant, blood pressure medication, synthroid, and a low potassium diet. The newest addition to this is Aranesp, which helps his body produce more red blood cells so that he's not anemic.

The Aranesp freaked me out. Pete has to go once a month to get a shot, and for his first shot the nurse told him something that we hadn't heard before. In the last six months, Peter's kidney function has gone down to 30%, 18% lower than it was at his last appointment. Because his glomular filtration rate is 38, he is in stage three of chronic kidney disease, but at the lower end of it. Stage 4 begins at 29.

So we are working on it. Pete has been working out, and I have been scouring the internet for different things we can do. We will be seeing a nutritionist that can help with a diet that is kidney-friendly. We've also been working with Best Doctors, which is a service that my company offers, and a world-reknown nephrologist will be going over Pete's charts to make sure that someone didn't miss something.

Normally I wouldn't post crazy medical stuff about either of us, but so few people have what Pete has, I felt like posting something about it would up the chance of someone finding me, be it a doctor, or someone else that has what Pete has. And maybe they can help us with their experience with treatments and what we should be doing right now. So I'm sending this out into the Internet, and hopefully someone will find it.

And aside from all that Peter is fine, by the way. It's just his kidneys that don't cooperate and like to freak me out. And I'm always up for a challenge, even if it's winning a war against my husband's kidneys! 

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