We drove to Rochester yesterday through a lot of rain. A LOT of rain. It was never bad enough by itself to really be terribly problematic, but when we slammed into a WALL of fog in the dark it got terrifying. I can't remember the last time my mouth went dry from fear. It took us quite a bit longer to arrive than typical, and it took HOURS for the adrenaline to wear off so I could sleep.
Babygirl's appointment was at 10. The lab opens at 8. She went in about 8:15, and came out unusually quickly. "They don't have any orders for me."
Well, that's a first.
I told her to hang out at the lab. I went upstairs, breezed past the check-in folks and knocked on the office door. I told them the problem, and they sent a text to the doc asking him to send in some paperwork to the lab ASAP.
As I was re-passing the check-in crew I got flagged over. As in, Do Not Refuse (please). I explained the situation and the lovely clerk told me that Babygirl could have had her labs drawn in Nephrology. Well, that's good to know, thank you - but there wouldn't have been any orders no matter where she was sitting.
It took a little while, labs were done, and we went back upstairs.
By that time, Nephrology had apparently forgotten we were there. Babygirl finally snagged someone as they were calling in another patient to remind them. We went in, got seen, got lab reports (all good). She was scolded for not checking her blood pressure (you HAVE met her right?) and not being religious about home labs. Her doctor then plainly outlined what worries him the most.
Most of his patients are more "ordinary" transplant patients, with an average risk of complications and rejection. Babygirl is NOT ordinary. I mean, I KNOW this, but it's alarming to have her be medically challenging to an extremely confident uber-specialist.
We've been hiking this highway for a very long time. I've kind of come to regard Babygirl as some sort of, I don't know, Average Abnormal? Trust this kid to be Above Average when it counts LOL.
Her risk of early rejection is substantially higher than average because she has antibodies to EVERYTHING. Her doctor wants to do all he can to detect rejection as early as possible. To that end he has ordered some (pick some random alphabet letters here/DNA) test to detect the possibility of early rejection. If I understood this correctly, this test measures the percentage of DNA in her system that doesn't belong to HER. If you consider that a kidney is only slightly bigger than your fist, the amount of foreign kidney DNA in her system should be proportional to her own (by weight? Volume?). If there is more kidney DNA than expected, even if the kidney seems okay by function, they'll look harder for signs of rejection. Likely via biopsy.
It only just now crossed my mind to wonder about DNA from the OLD transplant? I'm clearly a bit over my head in this, as always. I mean, I guess that would be distinctly different from the NEW transplant?
So someone will be contacting us regarding this (doubtless unGODLY expensive) blood test, which will be drawn at home by someone from whateverthehell biotech company invented this bad boy. Yippee.
To summarize: Babygirl has excellent kidney function, great cholesterol, undetectable diabetes. She has some expected-but-improving hormonal abnormalities common to renal patients that do not require immediate attention. Her liver is slightly irritable, go easy on the Tylenol. And as always, "Consider an IUD or other long acting birth control, and always use condoms" as one of her medications causes birth defects. Babygirl considers this a genuine non-issue but promises the doc that he'll be the first to know if that changes.
Lordy.
DeeDee
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