Babygirl's visit to Philly on Monday netted the worst lab reports we have had since the scare immediately post transplant. Her anti-rejection medication levels are fine. Her liver function is approaching normal finally. But her creatinine has risen a bit.
Creatinine is a by-product of muscle breakdown. Normals vary by age due to expected muscle structure. Kids should have very low levels - 0.6 or less is typical. Babygirl's new kidney got her to 0.7 for a day or two in the hospital, and settled at 0.8 from then until Monday, when it rose to 1.0.
Since this measure of renal function is exponential rather than linear, a 0.2 rise represents the possibility of a significant loss in kidney function, especially if it is the beginning of an upward trend, so the team's response to this was more intense than one might expect. Her BUN was also elevated, and that most likely indicates that she's a bit dehydrated. Since her native kidneys are still in place, and still probably dumping water, her new kidney is responsible for managing fluid balance in a more challenging environment.
Simply put, Babygirl has to drink more. A LOT more. But she's an adolescent. She's not allowed to use drinking fountains because of the possibility of infection. She's supposed to carry a water bottle at all times and drink at least two daily at school. But since no one else is allowed to do that, she's getting a lot of "That's not fair!" from her peers. So she doesn't want to carry the bottle. It's bad enough that she gets ragged for her chubby red cheeks - she can't leave THOSE behind. This she can control.
I had a conversation with her, the first, I assume, of many, about whether her peers' stupidity or avoiding going back on dialysis seems more important to her. I reminded her, as gently as I could, of how painful it was, and how much she hated it.
The tests were repeated yesterday. Creatinine is 0.9, and BUN is lower also, but this is spring break and no one is bugging her to do anything except drink.
Water shouldn't be a battle, should it?
DeeDee
It shouldn;t be a battle but kids are awful! They know her situation and should just shut up and be glad it wasn't them. Maybe the teacher should educate them a bit. Poor girl...battles at each stage of the game. Also, what harm would it be if the teacher decided to let all the kids have a water bottle. Good for them and also would be a way to let your girl not be the ONLY one.
ReplyDeleteI'm not sure why there is a "no water bottle" rule in the classrooms, altho I assume it's to avoid the distraction of having 20 kids crinkling bottles while the teacher is trying to work.
DeleteI'll ask, though. It's a good thought.
DeeDee
I have the same battle with my son...he has to drink a certain amount of water and/or Gatorade everyday to avoid lithium toxicity. I know how tough it can be to get them to drink. Hang in there!
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