90 Day Kidneyversary

I did not know this was a thing, but if you Google, there are a ton of links and images. I guess it makes sense since it is basically the beginning of a new life for the kidney recipient. Of course it had to be super commercialized but any excuse for cake is good!

My kidney transplant was on January 27th, so today is the 3 month/90 day milestone. The kidney is still working great. My latest creatinine results were a bit lower (better) than last week at 1.22, which translates to a eGFR of 68. Not perfect, but great compared to when I was on dialysis. I thought I would be done with UCLA clinic appointments, but evidently I need one more before they let me go. I also thought they would reduce my tacrolimus dosage, but it appears unlikely at this point. There was a post on Reddit about kidney recipient’s medicine list, and most people seem to have lower tacrolimus dosages. Luckily, I am only on two anti-rejection medications so maybe that is why I need more tacrolimus? Due to the perfect match with my sister, the nephrologist I saw yesterday said the kidney could potentially last forever, however long that is.

Crazy Traffic

I had a phone meeting at 9:30 am this morning with a coworker (actually my manager since I returned from medical leave). I got on the call at 9:25 am and he did not call in until just now. Turned out he was still driving. He lives in Orange County and takes the 91 freeway to work, but part of it was closed this morning. Caltrans rarely shut down freeways during rush hour so something big must have happened. Next, the off-ramp we need to take to get to work is shut down too for some reason. I just checked Google maps and you can see both closures.

Even worse, he said his Tesla is almost out of charge. Usually you have to get to work before 9:00 am to get a charging spot since there are more EV’s than chargers. He will probably need to find an open Supercharger before commuting home if he cannot find a level 2 charging spot in our parking lot.

Happy that I am working from home.

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Aftermath from an earlier police pursuit.

Healthy Choice Frozen Entrées

Typically my go to brand of frozen entrées is Marie Calendar’s. The food tastes pretty good, and they are not too expensive if you find them on sale. Albertsons seem to have them permanently on sale at $10 for three entrées. When I was at the market Saturday night, I picked up a couple of their café steamers entrees. The gimmick is that there is an outside bowl with sauce, and an inner bowl/basket with the food items. You heat the whole think up in a microwave, then combine the two parts in the bowl and eat. Once again, the photo on the box looks better than what comes out of the box.

Left is the “steam” basket that contains the chicken, vegetables, and rice. Middle is the sauce and sesame seeds in the outer bowl. Right is everything mixed together in the bowl.

First, it look like the entrée contained more food than reality. I can count 8-9 pieces of chicken in the box photo, and if you extrapolate the left 1/3 of the bowl, you would think there was probably a dozen large pieces of chicken. If you look at the left picture above, there was maybe 5-6 decent sized pieces of chicken, plus a few small pieces. Taste wise, it was so-so. Their own website shows a review score of 3.5★; I would have given it 3.0★: 2.5 for the food, and 0.5 for the “healthy” ingredients. The taste is typical for frozen meals, especially the weird carrot smell, but also bland since it only has half the sodium compared to other brands. The entrées from Marie Calendar’s are definitely tastier (relatively), but now too healthy for you, especially the salt content. “Healthy” probably just means lower fat and salt.

Nutritional ItemHealthy Choice
Sweet Sesame Chicken
Marie Calendar’s
Roasted Turkey Breast
and Stuffing
Serving size276 g336 g
Calories300280
Total Fat6 g7 g
Saturated Fat1.5 g3.5 g
Cholesterol35 mg40 mg
Sodium460 mg1010 mg
Total Carbohydrates43 g33 g
Dietary Fiber3 g5 g
Total Sugars13 g5 g
Protein16 g21 g
Calcium0 mg60 mg
Potassium490 mg630 mg

Hmm, they’re both kinda unhealthy, but convenient. The Health Choice entrée has a lot less sodium, saturated fat, calcium, and potassium (probably due to the mashed potatoes), but has more carbs and sugars. Ironically, the Marie Calendar’s entrée only received a 2.6★ on their own website. I guess it is a tie, and I should eat as few of these as I can.

Final Final Final Appointment

Ugh, they tricked me again. I went to UCLA transplant center for what I thought was the final in-person appointment before sending me back to my own doctors in Orange County. In fact, the appointment last week was supposed to be the final appointment, but the doctor decided to cut my tacrolimus dosage so he wanted one more set of labs to check levels again. Since the “normal” range is not provided on the lab results, I do not know if my number is high/low/okay. All I know is they cut my dosage when the result was 11.7, and they also think today’s result of 7.1 is a bit low. In addition, my calcium levels are 0.1 mg/dL above the high range limit, so he wanted to see another test before I go back to my regular nephrologist. All the other numbers, including phosphorus and potassium, are all within normal range. Blood sugar is still high, but I think I can lower it a bit by reading food nutrition labels and information on added sugars more carefully.

Since I am out of free nights at Tiverton House, I scheduled the appointment as late as I could, which is 11:00 am. That means I need to have labs done by 9:00 am, so I need to leave the house at 7:00 am at the latest. 50 miles from my house to UCLA takes over 1.5 hours during morning commute/rush hour.

The appointment is in two weeks.

Burnt Chicken Kabobs

One of my go to restaurants during COVID lockdown is Panini Kabob Grill. They have a fairly decent menu, but we always get the chicken kabob family meal. The two kabob combo is enough for the three of us, and I can usually pack a lunch for the next day as well. The chicken is really good and prices are not too expensive.

Website picture

This is the photo of the two kabob meal. It comes with your choice of kabobs, rice, and a salad. When we first started ordering, it was $20. Then it jumped to $25, but they lowered it to $20 again during the pandemic. Now the price is up to $27, which is still a good deal, if the food is good.

For dinner today, I placed an order online for the same meal. Usually the food is ready in 20 minutes but since it is Friday night, the app said ASAP = 51 minutes. Since it was only 5:40 pm, I placed the order anyway and the receipt said the food would be ready at 6:34 pm. When we got the food back home and opened up the container, the chicken kabobs were burnt. Some of the onion pieces were totally black and inedible. Also, the chicken pieces were really really dry. They were actually hard to swallow since it was so dry.

What we actually got

From the receipt on the bag, the food appeared to be ready at 6:05 pm. The app asks for your email address and phone number, but I did not receive any notification that the food was ready early. It probably sat on their counter for half-an-hour, getting drier by the minute.

It is really disappointing since we order from there several times a month. We also get the kabob meals when we order out at my sister’s house since everyone loved the food, and the quality is usually good and consistent. I sent a message on their website’s contact form, mainly to let them know that customers notice when they rush orders or provide lower quality food. I hope they get their act together so I do not need to find another place to get chicken kabobs.

Good thing there are a lot of options locally for “chicken kabobs”:

Map from Yelp search for chicken kabob

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The store manager returned my message the next day. She apologized, but mainly about having the order ready too early. Maybe it is some kind of passive-aggressive response. The message did not address the burnt or dry chicken kabobs, but she did refund my order. I was mostly okay with the food since I like charred meats, but the chicken was too dry to be enjoyable. I will likely still order from them but we will see if my parents will in the future.

Donor Billing

I received my first bill from UCLA for the kidney transplant. The amount due was ~$112 and it was for some pre-op charges for my sister, the donor. I checked my work insurance’s website and there was no rejected claim for that amount. Since I still have Medicare, they did pay for most of the bill, and UCLA billed me for the rest. I checked with my work insurance and they said transplant donor medical expenses are covered, before and after surgery. I also messaged UCLA’s billing department on Monday and they finally answered me today. Evidently, they do not have my secondary insurance information, yet the medical center has billed Blue Shield over a dozen times for doctor charges, hospital fees, tests, and pharmacy co-pays. It it a different account since the charge is for my sister? I believe they use a common patient number across all billing accounts so why are they missing insurance information?

To make things worse, you cannot include attachments to a message reply. You can attach pictures to the initial message, but only two files or something. Anyway, I ended up copying all the information on the insurance card in the reply message. Strange, they can perform a perfect kidney transplant in 3-4 hours but cannot coordinate medical data within the same building. I hope this resolves this billing issue.

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Here is the billing statement. The initial amount was $3,900 but there was an adjustment of $3,330.31, which is probably reducing the billed amount to the Medicare price of $569.69. Medicare then paid ~80% (not sure why it is not exactly 80%) which leaves a $112.75 balance.

Again, if I do not have insurance and pay for the transplant out-of-pocket, would I then be billed the full $3,900? That is messed up!

Another COVID Spike

So what is going on in Michigan? For awhile, it looked like COVID cases were dropping in the US with people getting vaccinated. It certainly looked like that in California and Orange County.

It appears that things are under control, and California is set to be fully open on June 15.

This is Michigan during the same time period.

The seven day average is finally decreasing but there was definitely another spike in early April. I do not follow Michigan news so I do not know what could have caused this. Is the state not getting enough vaccines? Did their governor open up the state already? Things are improving but we are still in the midst of the pandemic with new and more infectious variants popping up all the time.

I spoke to my cousin who is an ICU nurse in Toronto. She has many stories of anti-mask and anti-vaccine idiots there too. I thought it was just a crazy California thing.

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From this article, it appears they relaxed restrictions too early, and do not seem ready to apply them again. Own goal, I guess.

Final Final Appointment

I thought my in-person appointment at UCLA was the final one with the transplant team, but they told me to come back again this coming Monday. The doctor said they wanted to check my kidney ultrasound taken yesterday, plus they also reduced my tacrolimus dosage and wanted to see if lab results are stable after a week.

Speaking of lab results, the numbers all look pretty good so the medical team felt I am ready to go back to my regular doctors in Orange County.

TestResultNormal Range
Potassium4.73.6 – 5.3
Glucose13966 – 99
Creatinine1.330.6 – 1.3
Calcium10.18.6 – 10.4
Phosphorus2.72.3 – 4.4
Tacrolimus11.7N/A
Test results from UCLA Medical Center 4/19/2021

My creatinine levels are just over the high limit, but the doctor said it was still normal and stable so no worries. Glucose is still high but much better. Since my local endocrinologist is managing my insulin, they did not have any comments. The Tacrolimus levels jumped a lot from last test so they reduced it by 25% to three pills each time.

The transplant center also asked me to make an appointment with my regular nephrologist so I think next week’s appointment is the final one. I may have to go back every three months for a kidney ultrasound until they are satisfied that the lesion in my sister’s kidney is benign.

Unrecognizable

On my way to UCLA Sunday night, I met my friend at work to sign some paperwork. I am still his company’s unpaid acting-CFO, so there were a few documents for me to sign. I had to walk a bit down the street to meet him, and he said he could not recognize me until I was really close due to all the weight I lost. I have not met met many people outside of family and medical staff since March of last year so I will probably get the same reaction if I ever return to work onsite.

My weight has not changed much since the kidney transplant. I am still around 175-180 lbs.

Organ Donation Opt Out

Today I learned (TIL) that the UK has an opt out system for organ donors. Usually, to become an organ donor after death, you have to opt in, or make a decision that you want your organs donated. If you do nothing, it is assumed that you do not want to be an organ donor. With an opt out system, it is the opposite. It is assumed that you do want to be an organ donor unless you expressly say that you do not.

This is one way to try and increase the supply of donated organs. I am guessing that UK has the same problem as most countries, in that there is more need for donated organs than what is available. In my case, the wait for a deceased donor kidney is 8-10 years for my blood type. Increasing the number of live and/or deceased donors will shorted that list.

Having been on the transplant list for over four years, I generally agree with this approach. The UK system still lets family members have an input after the “donor” dies, and they mention taking faith, beliefs, and culture into account. Not exactly what that means, but it seems if any family member objects, then no organs are taken.

If a person do not want to be a donor for any reason, they can opt out, or tell a family member. I guess the impact will be for people who either want to be a donor or do not really care either way, and did not complete the opt in procedure. If that percentage is significant, then it will definitely increase the number of organs available for transplant.

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Huh. I just saw a US government website on organ donation. It states that 90% of people support organ donation, but only 60% sign up to be a donor. Not sure if it is 60% of the 90% (or 54%) but if we assume 10% of people do not want to become a donor, an opt out system may increase organ supply by ~50%. The issue is the statistics that says “only 3 in 1,000 people die in a way that allows for organ donation.

Urban Plates Dinner

My sister texted me about game night for tomorrow night. She bought some games from Jackbox Games, the maker of You Don’t Know Jack. I used to have a few of those games on my PC, but nowadays, the games are multiplayer and each person uses their mobile devices. Since I need to travel to UCLA tomorrow evening, we decided to move it to tonight.

For dinner, they ordered a bunch of food from Urban Plates, and since they are at a soccer game until late, I am food delivery boy tonight. I also placed an order for the same time for myself. Since I am still trying to count/cut carbs, I pulled up their nutritional information sheet, and tried to order wisely.

Initially, I wanted to get the Chimichurri Chicken, but for some reason, it has 60 grams of carbs, while the Grilled Chicken has none. It is often tricky to try and guess the carb content just by looking at photos or reading descriptions. For sides, I really wanted the mashed potatoes with grave (and the Canadian in me wanted fries for the gravy), but opted for Asparagus and Brussel Sprouts.

All this to try and control my blood sugar.

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Just got home. The food was okay. Brussel sprouts were really good, but the asparagus stems were a bit tough to chew.

USPS Informed Delivery

I downloaded the USPS app yesterday and signed up for their Informed Delivery service. It is free, and once you sign up, USPS will send you images of your letter-sized mail, and allow you to manage your incoming packages. Even though I mostly get junk mail, the service is pretty cool. For example, now I know that Citibank sent me some junk today:

I think if you are waiting for an urgent piece of mail and delivery is late in the day, at least you know in advance if it is arriving today. Since USPS will be sending me emails with images daily, I will need to make sure to delete them once in awhile, or I will run out of email storage space online again.

Court Packing

How do you know a politician is lying?

Because their mouth is moving…

It is no surprise that politicians lie, and they seem to lie most of the time.Trump is basically a narcissist and a compulsive liar. He lies about the most insignificant things, and those lies are often easily disproven. In response, the Democrats (not all of them) have come up with the most blatant and cynical bullshit that I have ever heard*.

Currently, Democrats are trying to pass a law that would expand the Supreme Court by four to a total of 13 justices. Why four? That is because the court is split 6-3 by political party. There are six supposedly right-wing justices and three left-wing justices. When asked, the typical “reason” for the expansion (or court packing) is that nine people should not be able to overturn the will of millions of voters. Hmm, then why is 13 better? Why not 11, 15, 21, or 500,000 judges? The only reason is that with control of both houses of Congress and the Presidency, Democrats think they can make the court split 7-6 in their favor. That’s all. All other reasons given are total lies. Not only were most Democrat legislators against court packing before they were for it, why the sudden increase now? Why not increase it slowly over time? Finally, since there is absolutely no reason to choose 13 over nine, what is to prevent future administrations and Congress to just add two, four, six, or n x 2 more justices each time there is a new election? You know if this happens and the results are what the Democrats are hoping for, if Republicans win the next election, they will definitely add more justices to the Supreme Court. Of course, the Democrats then will complain and whine about abuse of power and other nonsense at that time, they will absolutely not take responsibility for starting this mess.

People are different, and often disagree with each other. I think America has been successful because we believe in rule of law instead of rule by law. If Democrats pass this, then the US is no better than communist China, passing laws that are enforced only when it is beneficial to the ruling party. Of course Republicans are guilty of this too but the court packing proposal is the most disgusting example that I have seen, and threatens the delicate balance of power that is crucial to America’s stability and future success.

I am more upset about this than the $millions of taxes I paid in the last 20 years.

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*My comment excludes the Chinese Communist Party (CCP). When it comes to hypocrisy and outright lies, they have no equals, except maybe from Joseph Goebbels and the Nazis.

Old Acquaintance

I spoke to one of my college roommates from senior year today. We talked for about an hour. Normally not that newsworthy, but I think it has been 27 years since we were in contact last. He was our neighbor in our apartment complex freshman year (1986), and all of us living in both apartments became good friends. I think we lost track of each other when I started business school in 1993.

For some reason, his name popped up in my head yesterday, so I did a quick Google search. One of the hits was an online people search site, and one record looked familiar. I then sent an email introducing myself, and he replied. He ended up calling me today, and we talked about what happened in our lives since the mid 90’s.

The reason I am posting was because the conversation was a bit depressing in hindsight. The call was fine, and it was good to talk to an old friend. However, trying to summarize my life for the past three decades, it was 1) divorce, 2) CABG surgery, and 3) ESRD and kidney transplant. I did survive all that but it feels the most recent half of my life has been driven more by tragedy than joy. A bit dramatic perhaps, but my current situation is not how I imagined life when I was younger.

Being a Christian, I know I am supposed to be glad that I am still alive, have a good job, mostly financially secure, and all my immediate family are close. There is just some dissonance between expectations and reality of God’s mercy and grace.

Traditional Chinese Medicine

Since I am Chinese, I have grown up around Traditional Chinese Medicine (TCM). However, as I lived mostly in Canada and the United States, I have not been treated with TCM. I probably did have some herbal supplements before, and there was my experiment with acupuncture in treating my peripheral neuropathy.

Traditional Chinese medicine (TCM) is a broad range of medicine practices sharing common concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage (tui na), exercise (qigong), and dietary therapy.

Wikipedia

I am sure that through years of anecdotal evidence, there may be some basis for herbal supplements and even acupuncture. However, for major illnesses, I am highly skeptical about using TCM to diagnose and treat the illness. Even worse are the contorted explanations given to try and explain the efficacy of TCM treatment. From my limited experience, much of it is totally illogical, and runs counter to Western medicine or even basic science.

I bring this up because my aunt called my mom about my uncle (dad’s brother). He had a stroke several years ago. I do not remember the exact date, but likely early 2015 based on some data from Google Timeline. Since two out of three of their children were in Asia, I went to the hospital almost daily after work for a few weeks after his stroke. My parents were visiting relatives in Canada at that time; when they returned to LA, they took over the visitations. The stroke was pretty serious from the CT scans I saw. It turned out my uncle had several smaller strokes before, but he never noticed, nor did he go see doctors regularly. I think he was about 70 years old at the time.

The first few weeks at the hospital was pretty bad. He was incoherent, very agitated, and hostile to hospital staff. He did improve after a few weeks, and the hospital sent him to a residential recovery center. My aunt brought him home soon after that and has been taking care of him since then. He showed more improvements but lost a lot of cognitive functions. Meanwhile, my two cousins stayed in Asia, and the last/youngest cousin got married, so my aunt basically took care of him alone. The reason she called today was that my uncle deteriorated a lot recently. He can no longer speak and has lost bowel control. She was looking for information on homes for dementia patients, since my parents had to take care of my grandmother many years ago.

It did not have to happen this way. From secondhand information, mostly from my mom, my aunt relied on TCM to treat his stroke for the past five years. That means no CT scans, no anti-dementia medication, no Western doctor visits. What she had been doing was bringing him to a TCM “doctor” who gave him herbal medicine, and treatment that literally translates to “hitting the head.” (打頭)I cannot find anything on this online, but my aunt pays $40/session, and she gets the treatment done too. I am pretty sure it is not an effective treatment for stroke, or anything at all. Recently, after my uncle’s condition worsened, the TCM practitioner said his brain “shrunk” causing the new symptoms. How did they know? Did they do a brain scan? Nope. It seems like they put a finger on his “energy paths” to feel the diagnosis. Is this like chakra or something? Sounds suspiciously like nonsense to me.

I am not sure what happens now. My uncle used to be the president of a multi-national corporation with hundreds of employees. The cousin not in Asia has a PhD in some kind of medical field (I think occupational therapy). Her spouse is a nurse. The other two cousins went to well-known US universities. I seriously do not understand how things have gone so wrong without anyone suggesting a visit to a neurologist. My grandmother on my dad’s side had Alzheimer’s Disease, and I heard it is typically passed down from mom to sons. My other uncle (dad’s other brother) is also showing signs of dementia per another cousin. I think in addition to the stroke, the first uncle was showing symptoms of dementia too. That should have been a huge red flag to his family to seek professional medical help. It is probably too late now.

I am kind of sad. Although we were not super close (their entire family moved to Taiwan for many years before returning to LA), my uncle did give me my first office job. When I moved here to the US, I worked at a supermarket during the summer before starting my senior year in high school. After a few weeks, he gave me a job at his company, and I worked several years there (full-time summer and Sundays during school year). It was a much nicer work environment, even though I had to help out in the warehouse and drive a forklift occasionally.

I think my mom was able to convince my aunt to at least get a CT scan and get a diagnosis from a real doctor. Maybe there is room for improvement if he receives proper treatment now, but I am not hopeful. 😢

TGIF!

It is Friday! I survived my first week back at work. It has been a week full of meetings via Microsoft Teams, and lots of dead time. I still have a lot of stuff to catch-up, specifically training and a few tasks that have no one backing me up. Thankfully, I was keeping up with work email while I was out on leave, mostly deleting junk mail, so I am fairly current on new messages.

Since my 11:00 am meeting was postponed, I think I am going to finish the final late training course: Sexual Harassment Prevention for Supervisors. Since I did not have anyone reporting to me for a few months, I was told to complete the staff (non-manager) version of the training. Now that I have some staff reporting to me, I have to go through the supervisor version. Estimated time of completion is 120 minutes. 🥱

Every two years…

Maximum Insulin Setting

When my endocrinologist increased my insulin dosage, I thought it was a lot. I went from 8 units of Toujeo to 11 units in the morning, and from 8 units of HumaLOG to 12 units. This morning, as I was injecting myself, I wanted to see how high the dosage dials can go.

Well, it looks like Toujeo can shoot up to 80 units per injection, and HumaLOG can do 60 units. The pens do not hold that much insulin so if you need 60 to 80 units of insulin, the pens will run out pretty quickly. I am still using my first Toujeo pen since it was only prescribed a month ago. For HumaLOG, I am already on my third insulin pen.

Along with the pens, you have to buy needles separately. They are single use only, and are disposed after each injection. I also had to purchase a red sharp bin to safely dispose of used needles.

Insulin pen needles. I use four needles each day.

Air Filter vs. Humidifier

A week ago, I purchased a Blue Pure 411 Auto air filter. It has an automatic setting where the unit measure the “dirtiness” of the air, and adjusts the fan setting accordingly. I usually leave it on auto, and the fan setting has been on low this entire time.

I also have a humidifier that I used quite often, but have not used it recently. Yesterday, I filled the reservoir with water and turned on the humidifier. It was place about five feet from the air filter. I believe the air filter detected the water vapor, thought it was a pollutant, and kicked the air filter fan to high. At first I did not notice anything, but became aware of the loud fan noise. The air filter is very quite on low, but definitely not quiet with the fan on high setting.

Look like I cannot use both units at the same time…

Humidifier

Final Clinic Appointment?

During my video call with UCLA Transplant Center yesterday, the doctor (another one that I have not met before) scheduled the next appointment as an in-person meeting. She also schedule me for a kidney ultrasound. I get a feeling I will need a lot of these, primarily due to the cyst/tumor in my sister’s kidney that was left in there. The transplant committee did say that the risk of it becoming cancerous is very minimal, and it was too small to remove. Instead, they will just keep an eye on it with regular ultrasound scans. That probably means I have to go to UCLA regularly for ultrasound appointments.

She also mentioned that they wanted to see me in-person because it would be my three month appointment. Typically, the transplant center will turn the patient over to their local doctors after three months if everything looks good. I am basically only seeing nephrologists at UCLA at this point, so I would start seeing my regular nephrologist. She has been my doctor well before dialysis so probably five years at this point. She was also the doctor that convinced me to go to the ER based on my irregular heartbeat that turned out to be a possible heart attack and ended up requiring a CABG surgery.

Let’s hope with my blood sugar is better with the increased insulin dosage, and labs come back normal.

More Insulin

Ever since my endocrinologist switched my Humalog prescription from a sliding scale to fixed amounts, my blood sugar readings have been high. In addition, she added a second long-lasting insulin prescription for Toujeo.

Initially, I was told to inject 8 units of Toujeo in the morning, and inject 4/2/2 units of Humalog before each meal. Toujeo is a long-lasting insulin that is supposed to last the entire day, and Humalog is quick-acting, taken right before meals. The goal is to have blood sugar readings between 80 to 130. From the graph below, I have not hit that goal during the past 30 days.

I sent the readings to my endocrinologist this past weekend along with medication changes since I last spoke with her. Since she was out-of-town, a different doctor covering her patients replied and changed my prescription to 11 units for Toujeo, and 4/4/4 for Humalog. Hopefully, that will improve my blood sugar readings. I have been trying to eat a low carbohydrate diet, but it has not been working out too well. I hope some of this is a side effect of anti-rejection medications. My prednisone dosage is already pretty low, but I am still taking a decent dose of tacrolimus.

Overall, I have to jab myself four times a day. The needles for the insulin pens are really thin. Usually I do not feel much while injecting, but sometimes I hit a nerve or something and then it hurts really bad. I also test my blood sugar four times a day so lots of pinpricks on my fingertips.