Final x4 Appointment

Just when I thought I was out, they pull me back in!

Michael Corleone, The Godfather: Part III

Not a mafia boss, but that how I feel after the “final” UCLA post-transplant appointment. Not sure if I mentioned it previously, but they initially scheduled an in-person appointment, but changed it to a video call later. That meant I had to schedule a lab appointment in Laguna Hills. Since it was kind of last minute, my lab appointment was at 11:30 am. Not wanting to miss my tacrolimus and prednisone pills in the morning, I took them at 8:00 am as scheduled. As a result, my tacrolimus test result was through the roof, and ended up being invalid. There is no “normal” range given, but I read that from 7 to 11 is a good result.

Since the result was useless diagnostically, the nephrologist wanted me to schedule another appointment with them. I guess they want me case to be perfect before releasing me back to my regular nephrologist. That was not all however. The reason they asked for this past appointment was due to a high calcium test result. Well, it was even higher this time, though still small. They also added a new test for PTH or parathyroid hormone. My numbers while on dialysis was crazy high, like 400+, when normal is 10-51. This time, my result was 85, but I have nothing to compare to since this was the only result for this test. To counter this and high calcium, I was prescribed Sensipar. Instead of reducing medication, I picked up another one.

Finally, just to rule out some issue with my kidneys, UCLA ordered a kidney ultrasound. It was strange since I just got an ultrasound less than a month ago, but this time it was for my old kidneys. Sometimes recipients get cysts or kidney stones in the old kidneys, and one of the symptoms is high PTH. This time, instead of going to UCLA for the ultrasound, they were able to make an appointment for me at a site in Palos Verdes. Much closer drive, except it will be Friday afternoon when I am done. Probably the worst time to drive from South Bay to Irvine. Along with my no show podiatrist rescheduling, there were a lot of phone calls and coordination to schedule this latest batch of medical appointments.