re-hospitalisation is not a dirty word

g'day

Three months post transplant (19-8-10) is a significant milestone as these things go. All being well the specialist team begin reducing the high level of anti-rejection drugs. In my case, all was well, I began to feel safe, to relax and enjoy my renewed lease on life. A couple of days later I began to feel unwell, nothing extraordinary; an ache in the knees, an elevated temperature; it felt like the  flu. I duly notified the renal coordinator.

   "What do I do if I get the flu?"  

   "Take a couple of Panadol and monitor your temperature,
    if symptoms persist see your local doctor.

Sound familiar. The symptoms persisted on and off for a week with varying degrees of unwellness (depending on when I last took the Panadol)  Then one morning my temperature reached that magic number considered a fever in transplant patients 37.5C.

Tabasco on the right

Seeing my "local doctor" was interesting -  My normal local GP who'd been with me from the start of the kidney problem was miles away. I had recently moved and  intended to stay a while in the new place. So a new local GP was brought up to speed and on advice contacted an FMC renal specialist. The usual bloods & urine were taken and then something that was new to me; a blood culture. Blood is extracted directly into a small bottle of culture medium which when shaken looks like a bottle of Tabasco sauce.


The results I got the following day at clinic. There were signs I might have a couple of infections, maybe Staph and probably CytoMegaloVirus- CMV

Cytomegalovirus,  a common viral infection. In healthy people, it causes a mild flu-like illness (touché) that passes harmlessly within a few days. In certain high risk groups like ......da da
organ transplant patients, it can be serious.

More tests. If it was important my clinic specialist would let me know. I went home and forgot all about it until I got the call about 5pm, "Please report to FMC (Flinders Medical Center) emergency for admission, we need to put you on intravenous antibiotics."

Oh shit -  I guess it's important. 

FMC emergency waiting room 7pm after a hastily packing an overnight bag. We sat there for the next 4 hours hours before the long suffering Felicity had to go ( a long drive home). I got seen to about a half an hour later to get a Jelco put in and then back to the waiting room along with rows of patience in beds waiting for rooms. The only excitement was hourly measurements of blood pressure and temperature, eventually at about 2AM a bed was found in the EECU ( Extended Emergency Care Unit ) and the antibiotic drip connected.  All this played havoc with my sense of post transplant life;  3 months and I'm already back in hospital on a drip.

which one is the drip

Things were not as dread as they seemed however. The staph result for which the antibiotic drip was a precaution turned out to be a false positive. The CMV, while potentially dangerous, if caught early is easily treated with oral antivirals.

Cut to the chase: I was transferred to the renal ward and enjoyed a couple day of  government hospitality. Enjoy in this sense -  I wasn't half as sick as my fellow inmates, prompt attention by my doctors caught it in time.

I read some, wrote some, talked some, had three, two coarse (well not that course) meals a day and slept soundly. The Jelco stayed in until the last moment but was never used again and when they tried to flush it before removal it had healed/sealed over. I came home  a whole lot better with a varied pill regimen, less of the anti-rejection and  a course of antiviral.

I would guess this will not be the last time I will have to be re-hospitalised. It aint fun but it aint that bad; certainly better than dead. So unless I do a Howard Hughes and lock myself away from life, picking up the odd infection or two is inevitable as is a couple of days back on a renal ward.

Now I'm back to as normal as I'm ever gonna get - until the next time.

Ooroo

A piece of your Ear

Last week I went to the dermatologist with the expectation of finding something out about the recurring skin eruption that result either from the failing kidney or the heart pressure medications (I was going to say drugs but would be politically incorrect; drugs are bad, medication is good)

I have eruptions aplenty: the backs of my lower legs, two spots on my back (precisely placed to be unreachable to scratch), a spot on my belly where the catheter was after the operation to remove the kidney, a warty like spot or two on my left torso, a couple in unmentionable places, the outside of both ankles and a lump on the back of my neck.

None of these concerned the dermatologist, he was much more interested in my ears (eat your heart out Spock), in particular a spot on my right ear. This lead to an instant biopsy under local anesthetic - a piece of my ear removed - leaving me with the fashion statement pictured; very Spock like.

Today the results came back
(by email as requested )

Hi Rob,
Just a brief note to follow-up on your biopsy result.

This has come back showing a condition called Bowen's disease, which will unfortunately need further treatment.

Although this condition is not cancer, these spots have the potential to change into a certain type of skin cancer.
Therefore, we need to treat it to ensure that it does not transform into something nastier.

What? Nastier than a single dysfunctional polycystic kidney?

As I said earlier about all the work up tests for a transplant "...but what if they find something we didn’t know about and probably don’t want to know about." Now they have I think I'll rephrase it. " ...but Murhpy's law says if they go looking they're bound to find something I didn't want to know about."