April 11th, 2008

bundled up, walkabout, snow

Update on Flar and Background on CKD

Matt is drowsing off and on due to his pain meds, but he is doing well. He can get up and move around on his own - he even fixed his own breakfast this morning.

We got instructions at the hospital about caring for his incision and supplies to use when changing his dressing. The nurses helped him to sit up, and then I helped him to dress. We stopped at Kroger on the way home to drop off his pain med prescription, then I worked on getting him all settled in his recliner in the bedroom. He opted for his iPod, hot tamales and water. When the boys got home from tutoring club, I went back to Kroger and along with the medicine, I got him a plant to spruce up his bedside table.

One of the instructions the doctor gave us, and the nurses repeated, was that I was to stay with him for 24 hours after the surgery. This gave me a sense of responsibility to watch out for him while he got up and moved around. He moved into the family room last night for a bit, then back into the bedroom around midnight. Around 3am, he decided to try the bed. As soon as he was in it, he realized he'd be trapped there, so he woke me up. I helped him back up from the bed, then followed him around while he walked a bit. He settled back into the couch in the family room for the rest of the night. I didn't get back to sleep right away, so when it was time to wake up and fix breakfast for the the boys, I was sort of Zombie Mom. I got them up, fixed breakfast in time for them to leave -- Critter drove Tigger to school this morning, then I went back to sleep until almost 11, leaving Flar on his own. I also left out the ham from breakfast, which Flar put away for me when he got up to fix his own breakfast.

I don't remember how much I've written here about Flar's kidney condition. Flar has a condition, polycystic kidneys, which develops in severity over time. CKD stands for Chronic Kidney Disease, since the causes for kidney failure are many, but the treatment of the results is often similar. Flar's maternal grandfather and mother both died due to CKD. It affects men earlier in life; I don't know if Flar ever knew his grandfather. His mother didn't face kidney failure until she was past the current age limit for kidney transplant patients; I believe she was 74 when she died.

Flar's kidney function dipped below 20% last year, and he was placed on the kidney transplant list. Live donors would of course be the best alternative to cadaver donation. Unfortunately, I am the wrong blood type, Flar's brother also has polycystic kidneys, and many of our friends who have asked about it have either the wrong blood type, or medical conditions that exclude them as live donors. At the time, Gaucha volunteered to have compatibility testing done, as a potential live donor. This involves a lengthy interview about current health, and six vials of blood for various tests. She's the right blood type, O, and all of the other test came back positive for compatibility as well. However, when she started thinking of all the things that could potentially go wrong, she was afraid of the operation.

A few weeks before Easter, Flar had a toenail removed that has always given him difficulties with in-grown pain. While he was recovering from this surgery, he had a gout attack, achilles tendonitis, and a general infection. His doctor ordered blood drawn to confirm the gout diagnosis, and when his kidney doctor saw the numbers, he called him in. Flar had a dangerously high level of potassium in his blood, and his creatinine level indicated that his kidney function had dropped below 10%. For the first time in Flar's life, he was forced to cancel plans (for a trip to Brazil) due to his health. The doctor prescribed sodium bicarb to lower his potassium, and a low potassium diet. He also made arrangements for Flar to start the dialysis process.

Flar's potassium level is back within normal range now. He's not allowed a host of very common foods, like tomatoes and orange juice and granola and milk and the list goes on. He tries to limit himself to 2 ounces of meat a day, and is getting his protein from american cheese and eggs now.

Flar has elected to begin with dialysis with peritoneal dialysis. This is done at home, in his case it will be the eight hours while he sleeps. A glucose fluid is pumped into and out of his peritoneal region (the inside of the abdomen, surrounding his organs) through a catheter. This is what the doctor inserted yesterday. The peritoneal region apparently has blood in it, and the process of pumping this fluid in and out will leach out what his kidneys are no longer filtering out. Once Flar's catheter is completely healed we will be trained in how to do the dialysis.

He has an appointment with the surgeon on the 21st. Until that time, he is not allowed to drive, so I will be his chauffeur. I expect he will want to try to work some next week, since he is CFO of his investment partnership, and Tuesday is the 15th. The surgeon expects to find him sufficiently healed, that he will be able to begin dialysis, so it looks like that will start sometime after the 21st.

There is a company that delivers the fluids directly to the home. I remember the boxes and boxes stacked up at Barbar and Bébé's house. The bags look a lot like the syrup bags that are delivered to restaurants for soda taps. The boxes are heavy duty. I think we still have some around here, used to store up clutter in corners of the house.

I'm pretty much rambling here, but I think that's the general picture of it. We're having a lazy rainy day at home, and now I should probably see about doing some house work.