Another day, another doctor....
Today, it was the nephrologist, also known as a kidney doctor. His name is Dr. Brian Ayuste and he is in a medical office building not too far from home. Terry and Steve liked him. They said he agreed with Dr. Cox about the kidney problems being a result of the chemotherapy and dehydration and that Steve's kidneys should heal. Steve was ordered to drink 6 bottles of water a day for three days to combat the residual effects of dehydration. He has lab work to be done on Friday and then two weeks later he has a follow up appointment. Lab work will include a urine test to check for protein, plus blood work to check sodium, creatinine, ck (creatine kinase) and uric acid levels. Uric acid is a by-product when cells break down and is expected to be elevated after chemotherapy.
Dr. Ayuste took Steve off two pills, Lesarten and Simvastatin. Steve took Lesarten for blood pressure because of the diabetes medication, Actos, and the Simvastatin is a cholesterol lowering drug. Those pills affect the kidney's filtering function somehow and can be safely stopped temporarily without any side effects. He wants the kidneys unencumbered by extra filtering until they get working normally.
They will follow up regularly and reassess what needs to be adjusted in the future because the maintenance chemotherapy may continue to stress Steve's system.
The good news, Steve may still return to work on Monday if he feels up to it. Terry said he felt better today and only needed one Prilosec instead of two to help with his upset stomach. He might make it back on schedule after all.
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