So we made it back from vacation. Successfully, albeit in retreat.
Susan's been fighting toothaches for longer than she likes to remember and it really flared hours before we were to hit the road. So of course we went anyway. (She had seen the dentist and had an appointment with an endodontist for when we returned, it's not like the problem had been ignored.) To make a long story short, she obtained antibiotics and pain meds which helped, but instead of going on to the Great Salt Lake, we made the retreat back to Big D, where she immediately had two root canals.
And while she was having her morning in the dental chair, I wound my way through the maze that is Baylor Hospital, found the outpatient lab where they drew blood samples to check the serum BK Virus cell count. Yesterday I went to Dallas Transplant for the usual drill: labs and a check-up.
Good news bad news. The Ciproflaxcin really knocked down the serum cell count of the virus (That is the cell count in the blood). From close to 500,000 to 73,000. Normally the follow up here would be to wait and see if the reduced immuno levels would allow the body's antibodies to fight the virus before moving onto anti-viral infusion. Except that my creatinine took a stiff increase, from 2.0 to 2.7 (normal is under 1.1.) OUCH.
Information note: Creatinine is waste product from the muscles that the kidney clears from the blood. It is quick and easy to measure with a blood sample, so it is the most common measure of kidney function. It is not totally accurate as the appropriate creatinine level varies according to mass, body type and fat, age and even race. When put through a complex formula that's over my head, it becomes the Glomular Filtration Rate which is a much more accurate gauge of kidney function. But because of the ease and low cost of the test, measuring creatinine is the most common measure. And mine, which was high, just went higher.
So, what's next? I go in tomorrow for a recheck. Maybe I was dehydrated, maybe this, maybe that. A number of alternatives were floated that would have produced the elevated creatinine. They sounded like pie-in-the-sky to me.
Bottom line: I go in for a recheck. If it's down, we'll go into a 'wait-and-see' mode or go to the anti-viral. If it's up, it's back to the hospital for another biopsy. What would the biopsy show? Possible rejection due to the reduction of immuno suppressants. Possibly the Cipro knocked down the BKV in the blood, but the virus count is still high in the kidney. And possibly damage to the kidney by the BKV.
And yes, it is depressing to be back in this murky medical malaise. And then I remember. The last four years of dialysis and transplant have been such a blessing. Stoppage. Extra time.