Tuesday, August 10, 2010

The BIG "R"!!!

  That's Rejection... (not Ricki) Though neither one of us are to be feared, I'm not to be taken as serious as the big R. heheee... 
Why am I even mentioning the R word, bad ju-ju!!! (nope, I don't believe in that... just ask my surgeon, who after the 5th or 20th time of me mentioning my previous DIC episode before my transplant, finally looked over at me and said straight out... "Shhh, don't mention that word again, we don't talk about that in the hospital" ...Like I was the CRAZY one) Anywho, yesterday was my clinic day, and I knew it was going to be a long one because I needed my magnesium fix. The last few weeks I have been getting infusions twice a week, but this was the first time I had gone 7 whole days without it... and I was feeling it. By Sunday night, I felt like I could pass out at any second from exhaustion. However, when they did my lab work, they also found that my ALT and AST levels had slightly raised, which can mean rejection...
So, what's the plan? More hospitalization? Another liver transplant?? Possibly, but not likely... Most likely, they will just need to change up my anti-rejection meds... Ok, not "just" but they have been doing this for years now, and have gotten pretty good at it, so I trust completely that they know what they are doing and will get my body behaving nicely to Sally again. 
So last night, my nurse called me back and told me to raise my Prograf .5mg and come back on Wednesday morning to see if the counts have gone down any. If not, then... well we will take it from there, but most likely I'll be getting more USC tacos (and you know how I likes me some tacos) ...I'll keep you posted.
Below is some information on rejection (for us liver patients, different organs have different signs). It is the word that any of us transplant patients dread to hear, for fear of losing our precious gift. However, it is more common then I thought, and if caught on time, can be treated successfully. Whoo hoo!!

Rejection
The body's immune system protects a person from infection by recognizing certain foreign substances, such as bacteria and viruses, and destroying them. Unfortunately, the immune system recognizes a new liver as a foreign substance also. Rejection is an attempt by the immune system to attack the transplanted liver and destroy it. To prevent rejection from occurring, a recovering patient must take immunosuppressive medications, as prescribed, for the rest of his life.
In spite of all precautions, rejection episodes can occur. Up to 75% of all liver-transplant recipients will have at least one rejection episode, even though these people are taking immunosuppressants. The first episode often occurs within 2 months of surgery. Rejections are usually controlled by changing the dosages of immunosuppressive medications or temporarily adding a new one.
If detected early, most rejection episodes can be treated successfully. A patient should be alert to the signs and symptoms of rejection and inform his transplant team promptly if he has the following.
  • fatigue
  • fever
  • abdominal pain or tenderness
  • dark yellow/orange urine
  • clay-colored stools
A patient may not have any symptoms, but his liver-function tests may be abnormal, suggesting that rejection is occurring. This is why maintaining a strict appointment schedule with the transplant team is critical. When rejection is suspected, it is usually confirmed by a liver biopsy. Based on the results, the transplant team will decide the best treatment. As with all transplant patients, a patient may have biopsies at regular intervals to monitor his liver function.

1 comment:

Kristi said...

I hate the R word..... for all organs it is different in severity and symptoms, but no matter what it is an unwelcomed little jerk!

Hope they get your levels worked out! Gabriella is on Neoral instead of Prograff... so she is hairy instead of having the hair loss. Cant they just combine the 2 so your hair just stays the way it is?! LOL