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Maybe Hitting the Nadir….

 Last week Babygirl’s creatinine dropped to 1.2ish.  Now it’s up to 1.3something. 

Historically, Babygirl hasn’t paid a lot of attention to numbers. Up until the initial transplant failed, she chose the “ignorance is bliss” approach and she didn’t fuss about small changes.

While on dialysis, she became more aware of some significant consequences of her lab results:   Phosphorus will lead to calcification of your heart and lungs.  She was VERY religious about taking her phosphate binders and avoiding phosphorus in her diet.  She became aware of the physical symptoms of elevated potassium levels, and adjusted things accordingly. She learned the difference between hemoglobin (anemia) and hemoglobin A1c (diabetes). 

With this new transplant, she is Adulting.  (Example: It is currently 6 AM and she is up taking her antibiotic on an every 6 hour schedule, using her own non-mom alarm system.) I was, however, unaware of how tuned in she was to the kidney function numbers this time.  An in-the-car conversation about results made me aware that she is concerned about the upward bump.

Well. This kidney has had a hard ride. Damaged in whatever catastrophe killed the donor, traveling God alone knows how far, on ice for 27 hours and waking up in an entirely new body…

We discussed expectations.  This kidney may never work as well as the other kidney did.  However, lots of people live with low-level renal insufficiency for a very long time.  I told her about a colleague who had kidney cancer as a young child (extremely rare!) who has had a creatinine of 2 for the past 50 years.  We talked about the fact that the doctors knew in advance that this kidney might not recover fully (or even at all), but felt the risk was worth it because it was a perfect match, far less likely to suffer rejection in the long haul. The only back up plan was to continue dialysis. 

She has a better understanding of where she is right now.  The new kidney may not recover more than it has, so the creatinine may quietly bounce from 1.2 – ? for the next little while until, like the other kidney, it settles on a generally stable number.  It’s just that the other kidney rested at 0.9 which was, certainly, a happier number.