Last November, I signed up for a program called Omada through my online pharmacy. I posted about it here. The goal was to eat healthy and exercise to lose weight. I believe I posted a few things the first week, then promptly ignored the rest of the emails. I kept weighing myself and the mobile connected scale kept track. Here is my weight history. The original goal was probably lose 5% of my weight.

I started the SPR program on July 10th, which is the last high spike before the large drop. In three weeks, I have lost twelve pounds or about four pounds a week. My first goal was actually 200 pounds so if I keep losing weight at the same rate, I may be able to hit the forty-pound weight loss goal. Likely the weight loss will slow but I would be happy if I lost another fifteen pounds. That would bring me to 215 pounds or thirty off my high.

As for the program, I am still having issues with my burned fingers, and now my fistula is hurting. I can still feel the “thrill” a bit, but I cannot hear the fistula anymore. I hope it is temporary; I do not want to visit the vascular surgeon at this point post-transplant.

I had a call schedule with UCLA Transplant Center about the Natera Prospera program. I was asked to join a study post-transplant, and this is the first time the sponsoring doctor has scheduled an appointment to talk about it. Here is a description from Natera’s website:

Covered by Medicare, Prospera is a transplant rejection assessment test that uses a simple blood draw to evaluate the risk of rejection of a transplanted kidney.

Through the use of advanced cell-free DNA technology, Prospera increases a provider’s ability to identify otherwise undetected rejection that might lead to kidney loss. Catching transplant rejection as soon as possible can help providers develop a treatment plan to best protect the donated kidney.

https://www.natera.com/organ-health/prospera-organ-transplantation-assessment/

I think it is informative that the first sentence tells patients that Medicare covers the cost of the test. Since Medicare coverage only lasts three years after the kidney transplant, maybe that is the topic of discussion today.

Anyway, I joined the call at 9:55 am for a 10:00 am call. I then waited for twenty minutes before another doctor called me on the phone saying the doctor I was supposed to speak with was delayed and we needed to postpone it to 11:45 am. Doctors are busy people so I totaly understand last minute schedule changes. I just wish they would have called me earlier, so I did not have to sit in front of my iPhone waiting for twenty-fine minutes.

I had two doctor’s appointments yesterday morning. It was not planned, so fortunately they were at separate times. The first appointment was with my endocrinologist. My blood sugar has been slightly lower recently, but there is a lot of variability in the readings. She mentioned that I may have brittle diabetes, which is harder to control. The linked webpage does say that it is rare and typically found in type 1 diabetic s however. I may also have experienced rebound hyperglycemia that would raise my morning blood sugar readings even though I did not eat anything overnight. In the end, she just increased my insulin prescription again, and sent another referral for a CGM (continuous glucose monitoring) meter.

I was done at about 9:15 am but the next appointment was at 10:20 am. I sat in the parking lot checking my phone instead of driving home since I would be heading out right away again. The next appointment was with my nephrologist. She said my lab results were fine but asked me to take some vitamin D supplements since my level was low. We also talked about COVID vaccine, antibodies, and Evusheld availability.

At my previous appointment with UCLA transplant center, they said I should get Evusheld shots, but since I am not a high-risk patient, they do not have enough doses to offer it to me. My nephrologist said St. Joseph hospital only received 40 doses, and the transplant doctor is restricting access to only his patients. One of her other patients told her that UCI received 600 doses for some reason; their transplant program is not that large either. Anyway, her plan for me is to get an antibody test (I did that this morning). If I have zero antibodies after four Moderna shots, she will try and make a case for me to receive Evusheld at St. Joseph. If that is not possible, she will then refer me to UCI to try and get shots from there. I have not had an antibody test before so it will be interesting to see if I do have antibodies.

I finally got a kidney ultrasound two days ago. UCLA Transplant Center told me early on that I would need to get periodic kidney ultrasounds to check on the existing cyst in the donated kidney. This cyst was what held up my transplant for over three years.

I was scheduled to go in at 4:00 pm. By the time I checked in, the outpatient clinic building was deserted. The entire procedure took about 45 minutes, so I was out and home by 5:15 pm. Initially, there were some questions whether we were scanning the OG kidneys or the transplanted kidney. In looking up my records, the ultrasound technician mentioned that the last scan was five years ago, and she was the technician then as well; she has worked at the same clinic for 25 years. I have worked about 26 years since my last graduate degree, but it was spread over three (or four) companies.

My nephrologist called me up the next day and said the original cyst was fine. There were some other small cysts but nothing important. I am not sure if those were there before the transplant. There was also something that was a bit enlarged, but also nothing to worry about at this point. She will send the ultrasound to UCLA next week so they can evaluate the results as well.

So far so good after 10 months.

UCHealth Denies Kidney Transplant To Unvaccinated Woman & Donor

AURORA, Colo. (CBS4) – A Colorado woman with stage 5 renal failure was months away from getting a new kidney. Now, she and her donor are looking for another hospital after learning UCHealth’s new policy.

According to UCHealth, the majority of transplant recipients and living donors are now required to be vaccinated against COVID-19. Neither woman has received their shots.

https://denver.cbslocal.com/2021/10/07/uchealth-kidney-transplant-covid-vaccine/

So when my transplant was scheduled in late January, I was not yet eligible for a COVID shot. Unlike the two women in the article, I was super worried about getting COVID in the hospital and losing the kidney after waiting 4+ years. As I posted before, UCLA was basically out of ICU beds, and I had to share recovery with another patient, both of us crammed into a room designed for one bed.

Further down, the article says:

“It’s your choice on what treatment you have. In Leilani’s case, the choice has been taken from her. Her life has now been held hostage because of this mandate,” said Fougner.

Fougner says she hasn’t received the vaccine for religious reasons. Lutali hasn’t gotten the shot because she says there are too many unknowns. Until last week, neither woman thought they needed to be vaccinated for the transplant.

You can tell they are anti-vax idiots by their hyperbole. Really, “held hostage!?” Nobody is forcing them to do anything. They are free to find another transplant center (good luck!) that will do the procedure without requiring vaccinations. Both the reason they give is totally bullshit as well. What religion forbids a mRNA vaccine yet allows for a complex surgical procedure with lots and lots of different drugs. Is she not going to take anti-rejection medication post transplant? Those have more side-effects than any COVID vaccine. The donor is also stupid with the “too many unknowns” crap. There are hundreds of things that can go wrong with both donor and recipient post-transplant. I am pretty sure they had to follow a bunch of appointments and test to get to this point in the process; for sure me and my sister did. Are they going to reject what their doctors and surgeons are telling them at the very last step? Ugh.

Another thought. What if the recipient is willing to get a vaccine? Will the donor say “fuck you” and not go through with the donation if she needs to be vaccinated?

“Here I am, willing to be a direct donor to her. It does not affect any other patient on the transplant list,” said Fougner. “How can I sit here and allow them to murder my friend when I’ve got a perfectly good kidney and can save her life?”

The women haven’t been able to find a hospital in Colorado that will do the transplant while they’re unvaccinated. They’re now looking at other states.

More hyperbole. It is not murder. If the transplant recipient values anti-vax nonsense over her own life, then so be it. My prediction? They will come crawling back to the initial transplant center as they will not fine anyone else to do the procedure.

Sometimes it feels like I have a second job managing all the doctor appointments, labs, and medications. I previously posted about two stressful mail-order medication deliveries. It is pretty much the same with appointments. I just spent about a hour on the phone trying to line up various doctor appointments and corresponding labs.

So here is my schedule for the next few weeks:

At least I do not have to drive to UCLA on a Friday afternoon since the appointment is a video call. Otherwise that will be a three+ hour roundtrip drive.

On top of all this, I need to make an appointment with my dentist. I chipped a tooth while flossing. Actually, there appears to be a large cavity and part of the tooth enamel just fell off. Good think I have a few hundred dollars on my FSA account that I need to burn before the end of the year. 😠

==========

That is also three labs in three weeks. Each one is likely 5-6 tubes plus urine. My left inner elbow is going to be hurting and bruising again.