Weight Gain (updated)

I read that many kidney transplant recipients will gain weight post surgery due to either better appetite or side-effect of medication. For me, my weight has been pretty steady at ~80 kg since the beginning of February. Recently however, I have been gaining a bit of weight, about two to three kilograms in the past two weeks. Since I am still using the Fitbit Aria scale, all my weight data is recorded online:

It is hard to read the time scale, but this is one year’s worth of data. Right after surgery, I weighed 80 kg. That dropped to a low of ~76 kg, and now I am up to ~83 kg. The fluctuation is only about 5% either way, but I am not sure if I should be worried. While I was in the hospital recovering, the transplant dietitian did say that I need to eat a lot of protein, so I can heal properly. I also do not think my diet has changed recently so I cannot explain why my weight has been slowly increasing over the past four months. This does put me back into the “overweight” category using the BMI calculation.

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In WordPress, you can put a “feature image” at the top of the post, and you can choose from a bunch of stock images. I entered “scale” as the search term, and had to go through over 10 pages of images until I found a bathroom scale (see above). About 3/4 of the images were of snakes and lizards.

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Updated: 4:30 pm

Oops. I should read my old posts before writing a new one. I posted a month ago that post-transplant weight goes up or down, but a webpage at NKF just mentions weight gains. I guess if you had too much fluid, that would probably fix itself right away once your new kidney starts working. It does seem there are more drivers for weight gain over time pos-transplant.

I also found a real research paper about this topic. The results were:

There were 181 (48.4%) female patients, 334 (89.3%) with white ethnicity and the mean age was 44.4 ± 12.8 years. The mean BMI pre-transplant was 24.7 ± 4.1 kg/m2, and 35 (9.9%) patients were classified as obese; 119 (33.6%) as overweight; 187 (52.8%) as normal weight; and 13 (3.7%) as malnourished. After one year of follow-up, the mean BMI was 26.2 ± 5.0 kg/m2, and 61 (17.3%) patients were classified as obese; 133 (37.8%) as overweight; 148 (42.0%) as normal weight; and 10 (2.8%) as malnourished. Weight gain was observed in 72.7% patients, and the average increase was 7.12 ± 5.9 kg. The female gender, lower pre-transplant body weight, lower number of hospitalizations, and a kidney received from a living donor were associated with weight gain by more than 5% in the first year post-transplant.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243394

So, after gain after one year was 7 kg. I have gained 3 kg after 5 months so it is pretty consistent with the research paper. I will ask the UCLA transplant team on Wednesday when I up there for an appointment to see what they think.

Lokelma™

I picked up my prescription for Lokelma today. It is a new medication UCLA prescribed to lower my potassium in case they want to prescribe Losartan. Interestingly, I used to take Olmesartan, which like Losartan, is an angiotensin receptor blocker (ARB). ARBs are usually prescribed for high blood pressure, but UCLA wants to use it to treat my high hemoglobin.

I was expecting another pill to take, but Lokelma turned out to be something you drink. Instruction says to mix with 45 mL (oddly precise) of water and drink it. Not sure why AstraZeneca did not make a fast dissolving pill, and went with a powdered drink instead. I took a dosage about 15 minutes ago. There was really no taste, even though the water turned milky white.

From the website, the only side effect seems to be edema due to high sodium content. Unfortunately, each 5 g dose has about 400 mg of sodium. That is about 15-20% of a normal person’s daily sodium intake.

No More Sweating?

I am still sweating in general. However, I mentioned before that sometimes when I eat, I would starting sweating profusely, especially when I am eating something with carbs like a sandwich or pasta. There are times where I had to use several paper towels to wipe away sweat before it started dripping onto my food. The conclusion was that it had something to do with being diabetic, but no one I spoke with was sure of the cause.

Since the transplant, I have been distracted by a bunch of stuff, but I just noticed that I was not sweating anymore while eating. I will use Raising Canes as an example. Typically I will sweat a lot when eating their chicken fingers. It did not matter if I ate the food in my car or at home, the sweating would start right after I start eating. The last two times though, there was no sweating at all. In fact, I do not believe I have experienced any episodes of gustatory sweating post transplant. This is very strange since the transplant did not fix my diabetes, i.e., I am still diabetic. In actuality, due to a combination of anti-rejection medications and new kidney, my blood sugar is worse. Based on my fructosamine results, the endocrinologist thinks my A1C is above 8.0,, which is pretty high. All other things being equal, the sweating should be worse, not gone.

Maybe I should pose this question to my endocrinologist next time.

Mail Order Insulin Delivered

The insulin that my endocrinologist ordered arrived via FedEx today. I was surprised at how big the ~~box~~ cooler was. I guess it was similar to receiving and order from Freshly or other refrigerated goods. Per my FedEx app, the package was 15″ x 11″ x 10″ and weighed seven pounds. All that for a few insulin pens. Also, who paid for FedEx overnight shipping?

The package was a styrofoam cooler like you find at gas stations or dollar stores. It felt pretty sturdy, and the lid fit very tightly. When you open the cooler, there were six reusable icepacks, and a plastic bag with three boxes of insulin pens. Like I guessed previously, I received only one box of Toujeo with three pens, and two boxes of Humalog with five pens in each box.

Again, I do not know why they sent me only two boxes of Humalog. Their website did say I was out of refills, which is strange since the endocrinologist sent new prescriptions out last week.

I think I will keep the styrofoam box/cooler and stick it in the frunk (front trunk) of my car to carry stuff, or throw icepacks in it if I want to carry refrigerated or frozen groceries in the future.

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Thinking about this pharmacy model some more, it does seem very wasteful. What if I ordered one box of insulin pens each week (multiple prescriptions)? Will they send me multiple large heavy boxes? I think the answer is yes. Last time I refilled normal prescription pills with the online pharmacy, I messed up and clicked check-out (one button check-out no less) rather than add to cart. It means I placed three orders of one medication each, instead of one order of three medications. The cost to me was the same, but the pharmacy sent three padded envelopes via FedEx. That seems like a programming error. They should at least group medication for the same person on the same day. I am not sure what the solution is however. If the insurance will let me get three month’s worth of medication each time for one co-pay, i will gladly go to my local pharmacy. Right now, I end up paying three times the co-pay asa well as having to go there three times.

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Here are all the old empty insulin pens. I looked into recycling them but every website says to just dispose in regular trash.

Kidney Complications

So for over a month I thought everything was going well with the kidney except for a few borderline test results. However, my creatinine spiked two weeks ago so I had another video appointment with UCLA today. This meeting took much longer since the nephrologist was once again evaluating whether to release me to my regular nephrologist.

The issue this time is high hemoglobin combined with high potassium. My potassium has been borderline high since transplant, and this time, the result was 5.4 mmol/L:

The hemoglobin results post-surgery were super low since I had anemia while on dialysis, but it has steadily increased until it is now borderline high. High hemoglobin can lead to blood clots that may end up in the lungs causing pulmonary embolism, or the brain causing a stroke. Great!

Persistent high hemoglobin after a kidney transplant indicates post-transplant erythrocytosis (PTE). It is defined as having hemoglobin results above 17.0 g/dL and hematocrit >51% for six months. My numbers are 17.2 and 53.5%, but for just the last test. Nevertheless, UCLA wants me onsite next week to talk about options. They were going to prescribe me Losartan to lower the hemoglobin, but that can raise potassium, which was too high already. Instead, UCLA prescribed Lokelma to try and lower my potassium first. If they can lower my potassium and my hemoglobin stays high, they will also prescribe Losartan. Otherwise there is a procedure to physically remove the hemoglobin from my bloodstream. Obviously, I want to avoid that scenario.

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Back to the creatinine problem, this time the numbers were a bit lower at 1.39. It is still above normal range, but much better than 1.58. I did the same blood test a few days ago for St. Joseph Heritage, and the number was 1.50. Combined with the inconclusive kidney ultrasounds, the UCLA nephrologist was not concerned about any rejections.

Open California

So, after 15 months of COVID lockdowns and social distancing, California is lifting most restrictions today. Looking at recent cases and deaths data, it does seem that the vaccines are working, and the pandemic is under control, in California anyway.

*https://covid19.ca.gov/state-dashboard/*

This is cases data for Los Angeles and Orange counties. The trend is very similar to statewide results.

As for vaccinations, data shows 55% of California population are fully vaccinated with an additional 11% partially vaccinated. Assuming that there is some protection with partial vaccination, that is 66%. Not sure if this part is legit but if you add the total number of COVID cases, that gives another ~11%. Of course, there are likely many people that are vaccinated who previously contracted COVID, but maybe we are at 70% “immunity” already? Is that enough for herd immunity?

Personally, due to the anti-rejection medications, I will still need to wear a mask in most situations. Since most people will not be wearing masks, I need to start using the KN/N95 masks. I have been using a KN95 mask more and more, and it is not too bad. The only thing I am worried about is being harassed by anti-vaxx/anti-mask idiots that are harassing people that are still wearing masks.

Actual domestic Chinese KN95 masks from China. Employees from my friend’s company in Chengdu sent a bunch over when there was a huge shortage in the US.

Mail Order Insulin

When my endocrinologist increase my insulin dosage, I asked her to send new prescriptions to Express Scripts, a mail order pharmacy that my company’s insurance uses. The main benefit is that I can get three month’s of medicine per order, instead of just one month from my local pharmacy. The disadvantage is that stuff sometimes just show up without any warning, and you do not have the option to return it. At the local pharmacy, if anything is wrong, I can refuse the order, and they either restock it, or send it back to the drug company. Not so for mail order since the mail order pharmacy cannot be responsible for tampering risk once the drugs leave their site.

For example, my endocrinologist ordered both Trujeo and Humalog for me last Thursday. I immediately got an email from Express Scripts saying they are working on the order. For the next few days, it was radio silence. When I checked their website, it said both prescriptions were in progress, but with no additional information (ETA, cost, etc). Just now, the status for both said shipped. I guess I am used to the Amazon model where I get lots of email notifying me of my order status. Fortunately, the medications are covered by my insurance so I am not stuck with huge co-pays. Still, the Humalog will cost me $60.

It is also surprising how much non-generic medications cost. Nowadays, most prescription receipts include pricing so you can see how much your insurance plan paid. In this case, the Humalog, I am only receiving a 67 days supply. Even so, my insurance paid $900. When I first refilled the medication, I took it to my local pharmacy, and they charged me $30 for one month supply, which worked out to be five pens. Does this mean I get 10 pens for $60? If so, then there is no advantage for me to go with Express Scripts. The Toujeo was different. It only cost insurance $353 for a 90 supply, and my co-pay is $0.

Due to an overzealous doctor at UCLA, most of my prescriptions were converted to Express Scripts. The only difference is for Tacroliums as most pharmacies do not take Medicare Part-B for drugs. My worked insurance paid for it once, but I am sending the prescription to UCLA’s pharmacy to be safe. It takes a bit of effort to manage 10 prescriptions at three different pharmacies though.

SoCal Edison Billing

I just saw a “preview” of my bill for next month, and it is about $900. However, since I have solar panels installed, Socal Edison (SCE) effectively bills me once a year. Each month, I only get billed for basic charge, whatever that is, and it is only $0.031/day. That usually comes out to about $1/month. However, SCE is tracking my actual usage, calculating the cost, but deferring the actual billing. Since SCE screwed me on the original system install (limited system size), I never generate enough power to cover usage. If I look at my Tesla app, my solar system generates a maximum of ~22 kW each day. I am also unsure what that is measuring: is it the panel output, inverter output, AC or DC power? In any case, SCE adds my power usage and solar generation to get a net usage number, and that is applied to the tiered rates. Currently, tier 1 is $0.23/kWh, tier 2, is $0.29/kWh, and tier 3 is $0.39/kWh.

Earlier, I said SCE screwed me on the installation. Part of the reason I installed solar panels on my house is my Tesla EV. For some reason, SCE placed an upper limit on system size based on last 12 month’s usage. I believe we were using about 500+ kWh per month, or a rough average of 20 kWh/day. Well, my Tesla has a 72 kWh battery and gets about 3.3 miles/kWh. If I drive 100 miles round trip to work, that is about 30 kWh, which is greater than our base electricity usage without the EV. If I did not get solar panels and charged daily at home, that would put me at tier 3 every month, and it would cost me marginally $0.39/kWh to charge the car. Luckily, I ended up charging mostly at work and occasionally use a Supercharger.

So fast forward to this year. Since I paid about $800 last year, $900 this year sounds reasonable. There were some very hot days last Fall, and due to the pandemic, our family just hung out at home most of the time. What I am still confused about is reconciling power generation numbers. Last month’s bill from SCE says generation was 304 kWh. I went to the Tesla app and downloaded data for the same dates and got 516 kWh generated. Again, I do not know what each company is measuring. Hopefully, SCE’s number is measured at the meter so power in = power out. Unfortunately, solar panels generate DC so each system requires an inverter to convert DC to AC. I cannot remember what the conversion factor is. I know there is a √2 somewhere… pretty sad for someone with two electrical engineering degrees. 🥵

Low Blood Sugar?

Weird. My blood sugar was 216 this morning. Obviously, that is too high for a fasting reading. I then took my regular morning insulin shots: 13 units of Toujeo plus eight units of Humalog. I think it was supposed to be seven units of Humalog but I did not think one extra would matter. Anyway, I got on the work computer and totally forgot about eating breakfast. Soon, I started sweating and feeling lightheaded. It was a strange yet familiar feeling so I tested my blood sugar again, and got 88. If my blood sugar falls below 90, I start feeling symptoms of hypoglycemia. It is probably more noticeable since my body has been used to ~200 levels of blood sugar post-transplant due to new medication. I had to find my glucose pills and quickly took two of them, which gave me 8 g of sugar. It has been about 10 minutes and I still feel a bit woozy. My mom is downstairs making oatmeal so I think I should go eat some before I faint (not likely but still).

*https://www.verywellhealth.com/hypoglycemia-causes-risk-factors-1087616*

Grocery Shopping

I was bored this morning, so I decided to go do some grocery shopping with my mom. Typically my parents do all the food shopping and cooking. In return, I pay all the other bills for the house, including property tax and all the utilities. Not sure if that is fair; my payments are about $1,200/month, mostly for property tax.

Before going to the market, we stopped by the Santa Ana Raising Canes for a quick lunch. I only got the chicken fingers so to avoid extra carbs from the fries and Texas toast. I was looking forward to this since it has been several months since I ate there, but it was very disappointing. There was actually a line and a good 10 minute wait for the chicken fingers. Because of the delay, I was expecting fresh (hot) chicken finger, but they were just kinda warm and a bit soggy. Next time, I am going back to the Tustin branch .

The next disappointment was at Albertsons. We went to a different store that was on the way home. This store was bigger than the one closest to our house, so I was expecting them to have more stock. The most important item to get was the Pepsi Zero Sugar Mango. Both Pepsi and Coca Cola 12 packs were 3/$10.99. However, there was only regular Pepsi Zero Sugar on the shelf. I did see regular Pepsi with Mango, but that will definitely spike my blood sugar. Anyway, long story short, I ended up getting some Diet Coke, and a 12 pack of Diet Dr. Pepper. I know Dr. Pepper is the go to beverage for a lot of people, but I was never really into it. Ever since picking up diet soda again for the phosphorus, I have been looking for more variety of flavors so I thought I would give it a try.

In total, I spent about $50 today since I also got some more frozen entrées and other stuff. I also found some no sugar ice cream from Breyers. There must have been over a hundred types of ice cream in the freezer aisle, but this the only diabetic ice cream I could find. I thought there were a lot of diabetics in the US. Is there no demand for the special ice cream, or are people just eating regular full-sugar ice cream?

Nutritional information for the flavor I bought: vanilla chocolate strawberry. The ice cream is sweeting using sucralose, which is what is in Splenda. The important numbers are: 17 g of carbs, 0 g of added sugar (8 g of sugar alcohol), and 150 mg of potassium. Their regular vanilla chocolate strawberry ice cream has 20 g of carbs, 15 g of added sugar, and 170 mg of potassium. There is also twice the amount of fats and cholesterol. Hopefully it tastes ok.

Chinese Restaurant Recommendation

Awhile ago, I signed up for an account on Nextdoor, and I get notifications about new posts. Typically I do not pay that much important since nothing really important is discussed. Today, one notification popped up and it was someone asking for “authentic” Chinese restaurant recommendations. There were 97 replies so I was anticipating a shitshow in the comments.

I erased the profile pictures and names because Internet, but the OP was not Asian. Maybe his wife is Asian or even Chinese, but I am already irritated at the “I only eat authentic ethnic food” comment. In any case, there are a few authentic (not Chinese-American) Chinese restaurants in Orange County, mostly in Irvine. My expectation though was that some non-Chinese person was going to say Panda Express. I was not far off.

As you can see from the screenshot, the top reply was Orange Blossom. I have never set foot in the restaurant, but I drive by it all the time since it is locate on one of the major streets in Orange. They do not have a website, so the best I could do was a Yelp! link, which includes some menu photos. Pro tip: if you see items like Moo Goo Gai Pan, General Tsao Chicken, Chop Suey, or Egg Foo Young on the menu, 100% guaranteed that it is NOT an authentic Chinese restaurant. The food itself could be very tasty, and Orange Blossom is pretty highly rated on Yelp! and Google, but those are dishes created by Chinese immigrants to America. Instead of Moo Goo Gai Pan, which is an awful transliteration of Cantonese, a real Chinese restaurant may have Mushroom Chicken. It will of course have different ingredients and taste totally different, maybe better, maybe not. My point is that the guy asked for “authentic” Chinese restaurant recommendations, and most of the replies were for Chinese-American restaurants. Totally different.

I have fallen into this trap on Yelp! many times. When I first moved into the neighborhood, I looked for local Chinese restaurants. It was mainly for my parents, since I am fine with most cuisines and even Chinese-American food. I visited many of the more highly rated restaurants with comments like “greatest Chinese restaurant” and “awesome authentic taste.” Of course, it always ended up being a Chinese-American restaurant with cream cheese wonton appetizers and Moo Goo Gai Pan lunch specials. It was like if I was looking for authentic Mexican food and a bunch of non-Mexicans told me to go to Taco Bell or Chipotle. I mean I eat there sometimes, but no way is that authentic.

NGL, that looks kind of tasty. It will likely kill off my new kidney though with all that fat, sodium, and carbs.

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Since I talked all this trash about “authentic” Chinese restaurants, here’s where our family eats around the Irvine Area:

Ma’s House, Laguna Hills: Islamic Chinese restaurant. Food is pretty good, especially their large clay warn pots and sesame bread. No pork.
Tasty Garden, Irvine: Hong Kong cafe feel, with some western dishes. We like the Peking Style Pork Chops.
Sam Woo Seafood Restaurant, Irvine: This is old school Cantonese restaurant. I have basically eaten at Sam Woo my entire life, including branches in Toronto, Cerritos, LA Chinatown, Alhambra, Monterey Park, and of course, Irvine. The quality at the Irvine location has gone way down since the COVID shutdown however.
China Garden, Irvine: We mainly come here for dim sum. I have only eaten dinner here once. The dim sum is decent for the price, but there are better places much farther away in Monterey Park or Rowland Heights.
Din Tai Fung, Costa Mesa: Super expensive Taiwanese dim sum restaurant famous for its Xiaolongbao. Food is excellent, though the portions are small. Easily spend $30-40 per person appetizer level food. I have never ate at the South Coast Plaza location, but have been to branches in Taipei, Seattle, and Torrance.
There are several more smaller, more specialized restaurants that we visit often, such as Kingchops, Tasty Noodle House, A&J Restaurant, and several others I cannot remember right now.
Not that Chinese-American food is bad. I sometimes go to Pei Wei or Panda Express too.
Places that are likely authentic but I have never been: Tim Ho Wan (Hong Kong style dim sum), Haidelao (Szechuan hotpot), a bunch of restaurants that specialize in a specific Chinese provincial cuisine such as Beijing, Shanghai, Cantonese, Hunan, and Szechuan.

New Tesla Supercharger (updated)

I just saw it today on the Tesla app. When you click on charging, the app shows you the nearest charging spots. Evidently, the new supercharger site in Irvine is the closest to my house now. It is located in Heritage Plaza, near Culver and Walnut. The chargers are literally right in front of Daiso and Mitsuwa; man, it is going to be super crowded all the time. Right now it is 7:00 am Friday morning, and the app says there are 10/16 stalls free. I read on Google Maps that these are 250 kW chargers. I have never had success with getting more than 50 kW of power from a supercharger. It may be higher right when I plug in, but always seem to drop down to 50 kW or lower, even though the v1.0 chargers are supposed to support up to 130 kW. I am finding that Tesla’s specs on their cars are a bit flexible when it comes to charging and range.

There are a lot of local chargers now. When I purchased the Model S in late 2016, there was only two supercharger sites on this map: Fountain Valley (lower left) and Main Place Mall in Santa Ana (not marked due to weird zoom). All the chargers were full 24/7 because there were only Model S/X available, and most included free lifetime supercharging. Now that Model 3/Y have to pay for supercharging, hopefully the new chargers will not be too full since most people should charge at home.

Since I need to drive down that way to get labs done for UCLA, I think I will leave 30 minutes early and stop by the new supercharger and see if my old Model S can charge faster than 50 kW. I have not driven the car outside of Los Angeles and Orange counties since charging is a bit slow. If I can charge fast on the new v2.0 chargers, I will feel better with longer road trips.

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My friend sent me this photo of the Harris Ranch supercharger along the I-5 freeway. This site gets a lot of traffic since it is about midway between Los Angeles and San Francisco Bay Area. Tesla is going to build out the largest supercharger site with over 100 chargers. Assuming they are all v2.0, that means a maximum power draw of 100 x 250 kW or 25 MW. That is crazy! He also said they were putting in solar panels. That probably will not be enough to power even one charger.

*Harris Ranch Supercharger under construction*

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Well, these are not 250 kW chargers. Usually they have a small tag on the top of the charger that says 250 kW. These do not. I am getting about 35 kW which is terrible.

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I mentioned above that any new Tesla Supercharger site in Irvine will be packed since it seems every household has one. This is especially true in a shopping plaza with Asian stores. Well, here is the map from Bestla (a new Tesla app I purchased for $10). As you can see, the Heritage Plaza Supercharger I went to this morning is completely full, and the next closest site only has two stalls free; I believe this is the one by Honda Center/Anaheim Stadium. Tesla made an error offering unlimited free Supercharging for the old Model S/X. You never give Asians free shit because it will come back and bite you in the ass.

Frozen Pizza Lunch

After returning from the endocrinologist office this morning, I did some work on the computer, then took a short 45 minute nap. Since I did not eat breakfast, I was a bit hungry and decided to look in the freezer. I found a package of frozen pizza I bought several months ago and thought I probably should either eat it or throw it out.

I do not eat pizza that much, and almost never have frozen pizza. This pizza was from RED ROBIN and it the Single Supreme Deep Dish Pizza. I was super lazy so I cooked it in the microwave oven instead of my toaster oven, It was 3 minutes versus 25 minutes plus preheating time. I only cooked one pizza; the second one will definitely be cooked in the oven. Overall, the pizza was fine. It did not taste that different from a national chain pizza like Domino’s. I could definitely taste the sausage and green peppers, in addition to the pepperoni. Unfortunately, due to the microwave cooking, the crust was too hard on the outside, and kind of soggy in the middle. The package also contained a silver liner for use in the microwave to brown the crust.

Here is what the pizza looked like after 3 minutes on high in the microwave:

Again, I think the crust would be much better cooked using a conventional oven. The oven would also toast the top of the pizza as well instead of just melting everything. Since the microwave cooks so fast, it was a little uneven. Actually, the top-left part of the pizza was melted more than the rest, and some cheese overflowed and was burnt on the silver liner. I would give it 2.5 ★, which means just average. If the crust was better coming out of a regular oven, I would bump it up to 3 ★. In comparison, I would give our local pizza store a 4 to 4.5 ★ for their supreme pizza, but it is $20 for a medium. Since I am not a big pizza eater, I probably will not buy this or any other frozen pizzas in the future. If I really want pizza, I will just order it from the local restaurant.

Nutritionally, it was what I expected from pizza: bit too much saturated fat and sodium. I was surprised that it did not contain more carbs, but I guess it was only in the crust. I think eating one was fine for lunch; eating both would be way too much fat and sodium for just a single meal. Also, it looks like there is some weirdness on the DV% calculation for iron and potassium.

Endocrinologist 6/10/2021

I just came back from an appointment with my endocrinologist. I was kinda dreading this appointment since my blood sugar has been hard to control since the transplant surgery. However, the meeting went pretty well, but I did have my insulin dosages increased. The morning Toujeo was increased to 13 units in the morning, and I am back on a sliding scale for the Humalog, though the scale is different than what UCLA originally prescribed. The base dosage was increased from 4 to 5 units, and I need to add more if my blood sugar is above 150.

The fructosamine test from Tuesday also came back. The endocrinologist said that my result of 401 is comparable to an A1C number of ~8.0. That is way too high and she said it also may affect my new kidney. Going forward, I need to send blood sugar readings to her every 1-2 weeks. Interestingly, they took my blood sugar meter during the appointment to dump the data. They must have a computer that can read all brand/model of meters.

Peripheral Neuropathy 6/8/2021

Life sucks. Sure, it sucks a lot less without dialysis, but there are still lots of health issues to deal with.

I was working on the computer at around 6:00 pm when I got a huge spike of pain on the inside of my left foot. Instead of going away and spiking periodically, the pain basically stayed for an hour. It was a bit less intense but still pretty painful nevertheless. Afterwards, the pain started shooting again for about three hours. I think it is mostly subsided now, but I was screaming into my pillow more than once.

It is super frustrating since I do not understand the pain mechanism or drivers. Why does it start up at random? And what exactly is causing the pain? What if I gave myself a lidocaine shot? It is combination of intense pain, and feeling helpless to do anything about it that really drains me in the moment.

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Speaking of medical issues, I had to get another blood test today for my endocrinologist. Her sent me documents via mail yesterday so I had to run down to the lab today. I waited about 20 minutes since I did not have an appointment, but everything was fine and they only drew two test tubes: one for a comprehensive metabolic panel, and the other for fructosamine. Not sure why the endocrinologist likes that test vs. an A1C now that I am no longer on dialysis. The results are out already and similar to UCLA’s results, several items are high. Glucose id definitely high at 150-something, but I know that going in. Potassium is at 5.5 so borderline high. Creatinine is 1.50, which is lower than the 1.58 a few weeks ago, but it is still on the high end. I have to doe the same test again for UCLA on Friday so hopefully it will continue to drop.

Post-Transplant Insomnia

It is getting worse. For about several months after the transplant, I was sleeping pretty well, especially compared to pre-transplant. However, I am having more and more difficulty falling asleep, and staying asleep. Right now it is 3:40 am, and I have not been able to sleep yet. It has been like this for three nights in a row. For nights that I have been able to fall asleep, I would get up around 2:00 am, then stay up the rest of the night. During weekdays, I end up taking several short naps in between work calls just to remain semi-functional.

I am hoping it is my body adjusting to medication, although that has not changed for almost two months. The only big change is the addition of Sensipar for calcium and PTH levels. I do not know if the insomnia is a side effect of that drug, or in combination with an existing medication.

I have not mentioned this for a long time, but the general numbness in my feet from peripheral neuropathy is definitely worse. It is sometimes difficult to notice changes over time, but I am 100% sure the buzzing is much more intense, and I can barely move my feet and toes below my ankles. Since the primary cause is diabetes, maybe the higher blood sugar post-transplant is aggravating the condition? It is still bearable but contributes to my insomnia as it is hard to ignore when trying to fall asleep.

Google Timeline: 12 Months

Google sent me a notification today that my May 2021 timeline is available, whatever that means. So I went to Google Maps and selected Timeline to see how Google tracks my movement 24/7 (or my iPhone anyway). I then compared last month to May 2020. Not surprisingly, there are a lot more dots on the 2021 map.

This is May 2020:

The dots are: home, work (probably when I “stole” my 30″ monitor), St. Joseph hospital/dialysis center, my sister’s house, and a local Tesla Supercharger. There is also a dot in a in a nearby park, but I do not remember that. This was early in the lockdown so I am almost certain the parking lot gate was locked.

Here is May 2021:

Same dots as May 2020, but a lot more, including UCLA (post-transplant), dentist, other medical appointments, markets, and outdoor food courts for church cell group. The dot in the upper right is the Big Bear trip from last weekend. That is the furthest I have been from my house in about two years. Pretty sad. It is only four days into June and the timeline map already has more dots than May 2020. Another sign that maybe life is slowly returning to normal.

Mango Cola‽

Yup! Actually Pepsi Zero Sugar Mango.

On my way home from UCLA today, I stopped by the second Albertsons within 5 minutes from my house and bought some diet soda and iced tea. Last time, Coca Cola products were selling for $10.99/3 dozen, but today it was $4.99 per 12 pack. Pepsi stuff was slightly cheaper at $13.00/3 dozen so I started looking for diet Pepsi. Instead, I found this! I ended up only getting one 12 pack; the other two were diet cherry and just regular diet Pepsi. I should have bought more since it tastes pretty good. You can tell the flavor is artificial, i.e., there is no actual mango juice in it. It kinda reminds me of the flavor of mango pudding you get in some dim sum restaurants. It appears to be a limited time item so I need to go back and get more before it disappears off the shelves.

Of course there is a YouTube video:

Nutritionally, it has no calories, no carbohydrates, and no sugar added. It is sweetened with aspartame, and does contain phosphoric acid. That’s all fine. It also contains potassium sorbate, potassium citrate, and acesulfame potassium however, but the nutrition label does not call out potassium content.

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I am pretty sure I saw this in Japan. I am fine if that stays in Japan.

I will drink this one however, if it is imported from Japan. I love anything (sweet) with red beans. Probably lots of sugar and carbs though.

I-405 = Freeway Hell

So I went to the main UCLA campus for a couple of kidney ultrasounds today. The appointment was at 2:00 pm. Since it is Friday, I knew traffic would be bad. Still, I spent a total of 4 hours driving today. I left my house at noon-ish, and arrived at UCLA at 1:20 pm. Since I needed to pick up a prescription, that worked out well. The radiology lab was super busy today. With half the seats blocked off due to COVID measures, the waiting room was almost fully occupied. Surprisingly, I did get called at the appointed time, and the ultrasounds took about an hour. The tech was very nice and talkative, so much so that I thought about telling him to pay attention to the procedure. 😀

I paid for parking ($14!) and left UCLA at around 3:00 pm. At first both Tesla navigation and Waze showed a two hour drive back home. As I drove, that slowly grew to two and a half hours. While the Tesla onboard navigation told me to stay on I-405, even though it was basically a parking lot, Waze kept trying to route me off the freeway and onto surface streets, all to save a few minutes. I ignore Waze. With Autopilot in heavy traffic, the Tesla can really drive itself. There are no intersections or pedestrians on the freeway, and it is trivial for the navigation computer to hold the lane and keep distance. IMHO, it is much more work to drive on local streets. I did cheat a bit in Long Beach by driving in a few off-ramps that merged back onto the freeway, along with probably thousands of other drivers. That saved about three minutes according to the nav computer.

One think I did notice though is there are a lot of terrible drivers. Either they are incompetent, or being intentionally dangerous. When Autopilot is engaged in my Tesla, I usually relax more, and get to “spectate” a bit. You really notice how aggressive or entitled some drivers are. I would bet that a lot of the actual traffic slowdowns are caused by inconsiderate drivers forcing others to brake so they can save a few seconds, or jump one space in line. I also saw several cars driving on the shoulders at fairly high speeds while the regular lanes are stopped. Super dangerous.

I guess I am spoiled from not driving to work for the past 15 months. One silver lining of unknown vaccine efficiency for transplant recipients is still having a (good) excuse for avoiding crowds. I will likely not have to go into work until we start having COVID vaccine booster shots.

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Almost forgot. Since the ultrasound took about an hour, the tech turned the computer screen towards me so I could see the actual images and videos. He also explained a few things to me. It was pretty interesting to see the actual kidney and blood/urine flow in/out of it. Too bad I did not take a photo; my phone was stashed on a chair along with the other stuff in my pockets. I also did not realize how big a kidney was. A few people were posting pics of their “new” kidney. Maybe these were deceased donor kidneys? UCLA certainly did not show me my sister’s kidney before they transplanted it in me.

*https://www.openaccessgovernment.org/tackle-kidney-disease/76397/*

Not sure if that is a real kidney or just a model for a stock photo, but it is pretty large. I have three of them now. Doctors said bad kidneys will atrophy so maybe my two old kidneys are taking up less room.

Cameras

My sister just purchased a new camera. It is a Sony A7iii and it is pretty nice. It is also pretty expensive. Just the camera body was $1900, and her first lens was about $800. She has an old Nikon SLR with a few lenses that she will likely pass on to my niece. I also have a few cameras at home, none of them are recent however. The “newest” camera I have is a Sony a55 SLT. I also have a Sony a100, which can share lenses with the a55. I even have a Sony QX30, which probably no one else has:

It is a decent camera with no screen or viewfinder. It connects to your smartphone via wifi and is controlled through an app. I bought it used thankfully, and have never taken a real photo with it yet.

Anyway, even with a real SLR and a bunch of lenses, my favorite camera is an old Sony RX100. This is the first version of the camera; they are up to version VII (7) now. I bought the camera new many years ago for ~$600. Used models are still going for ~$300. The new RX100 VII is $1300 on Amazon.

For a tiny point-and-shoot camera, the RX100 has some pretty good specs. The image sensor is 20.2 MP; my Sony a55 is only 14.something. It also has full control over shutter speed and aperture, much like a full SLR camera. The lens is pretty bright at f/1.8 when zoomed out so I can take indoor photos without a flash. And it is light. When I travelled to Tunisia and Asia, I usually leave the SLR at home and carry this camera. The only issue I have is that the max optical zoom in only 3.6x. Sometimes you want to zoom in more, and there are point-and-shoot cameras out there with 10x optical zoom.