Healing at a Turtle's Pace

Steve and Terry went to the nephrologist's tonight to get the results of Steve's tests. They received good news and are doing happy dances as I type. Steve's 24 hour urine test and kidney ultrasound were fine and normal. Measures of Vitamin D and parathyroid functions were also normal.

They said Steve has Acute Tubular Necrosis, also called ATN, which is a problem with the small tubular structures inside the kidney (it is a precursor to acute renal failure). They were collapsing because of the chemo and dehydration and it is expected to only be temporary. Dr. Ayuste talked to Dr. Hu and discovered Steve had been sick longer than he originally thought, for the greater part of the eight weeks prior to their meeting, not just the last week of chemotherapy. That accounts for the slower recovery than he originally expected.

Kidney function is related to blood pressure. Dr. Ayuste took Steve off his Losartin medication back when this kidney problem started. Today, Steve's BP was slightly elevated at 160/97 (of course, he was stressed at the doctor's office and had just rushed there after a nine hour work day). He is starting Steve on Norvasc instead of Losartin to lower blood pressure since it is more gentle on the kidneys.  Terry has to buy a blood pressure cuff and check Steve's BP regularly while they adjust the dosage.  They don't have to see Dr. Ayuste for six more weeks. They already have lab work done every two weeks for Dr. Hu and a copy of the results will be sent to Dr. Ayuste so he can continue to monitor Steve's labs.

Constipation continues to be a problem. Apparently, it is a side effect of anti-nausea medications as well as the previous chemo itself.  Steve has continued taking the Zofran to help settle his stomach. He has other medications to help mediate the symptoms but it has not been enough. They have telephoned Dr. Hu and Dr. Cox at different times to help find something that works and they have doubled the dose of Colace recently. They also have to change from Citracel to Metamucil and he has Miralax available. They all work in slightly different ways to achieve the same end results :) Dr. Ayuste suggested they ask Dr. Cox about using Reglan instead of Zofran to see if it works on the nausea with fewer side effects. When I read about Reglan online, however, I see some pretty serious side effects (tremors and involuntary muscle movements) that seem much worse than constipation. We will see what Dr. Cox says.

Speaking of nausea.... Steve still is losing weight. The last I reported, I believe he weighed 257. That was monumental as the first time he reached the 250's since he was young. But, he told me he is now down to 247 pounds. That's just unheard of for my little brother. We're going to have to bulk him up with some muscles and enticing food. Wish us luck.

Steve's next appointment is May 18th with Dr. Hu with blood work scheduled several days before. Let's hope for some nice, lower kidney numbers.